Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04438 | Date 28/03/2019 |
| Token No | SM/18-19/11423 28/03/2019 | Serial | 025 Last Visit: 13/06/2025 |
| Patient Name | Mrs. SHUKLA MALLICK | Contact No | 9800779922 |
| Address | 56 CHATRA DUTTA PARA | Age | 40 Years,5 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||