Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 16324 | Date 28/11/2025 |
| Token No | SM/25-26/8802 13/12/2025 | Serial | 051 Last Visit: 13/12/2025 |
| Patient Name | Mrs. SUMITRA PAUL | Contact No | 8974167147 |
| Address | 489 (321/C) G T ROAD SHITALATALA CHATRA SERAMPORE | Age | 58 Years,4 Months,14 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||