Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00118 | Date 04/08/2018 |
| Token No | SM/18-19/401 11/08/2018 | Serial | 033 Last Visit: 19/11/2025 |
| Patient Name | Mrs. BASANTI DAS | Contact No | 9088717867 |
| Address | 26, CHATRA DHARMOTALA | Age | 64 Years,10 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||