Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 16360 | Date 13/12/2025 |
| Token No | SM/25-26/8800 13/12/2025 | Serial | 049 Last Visit: 13/12/2025 |
| Patient Name | Mrs. SANDHYA RANI SANYAL | Contact No | 9874240134 |
| Address | 6 NO LAHIRI PARA LANE CHATRA SERAMPORE | Age | 90 Years,11 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||