Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00003 | Date 01/08/2018 |
| Token No | SM/18-19/6028 31/12/2018 | Serial | 027 Last Visit: 20/05/2025 |
| Patient Name | Mrs. LABONI DEY | Contact No | 9433132426 |
| Address | 2 DUTTAPARA LANE | Age | 42 Years,4 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||