Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00121 | Date 04/08/2018 |
| Token No | SM/18-19/4220 27/11/2018 | Serial | 012 Last Visit: 06/12/2025 |
| Patient Name | Mrs. UMA BARIK | Contact No | 8420925894 |
| Address | 56 CHATRA DUTTA PARA SERAMPORE | Age | 59 Years,11 Months,4 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||