Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02724 | Date 28/12/2018 |
| Token No | SM/18-19/11536 29/03/2019 | Serial | 044 Last Visit: 18/12/2025 |
| Patient Name | Mrs. RITA DAS | Contact No | 7595904014 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI (M) | Age | 47 Years,11 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||