Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 16379 | Date 22/12/2025 |
| Token No | SM/25-26/8946 22/12/2025 | Serial | 004 Last Visit: 22/12/2025 |
| Patient Name | Mrs. JYOTI HARI | Contact No | 8981606153 |
| Address | 18 BAZAR BYE LANE,SERAMPORE | Age | 35 Years,9 Months,25 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||