Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06068 | Date 06/08/2019 |
| Token No | SM/25-26/8962 27/12/2025 | Serial | 005 Last Visit: 27/12/2025 |
| Patient Name | Mrs. MALLIKA SETH | Contact No | 7998216605 |
| Address | 470/309 G. T. ROAD,BOUBAZAR,BAIDYABATI(M) | Age | 49 Years,11 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||