Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03120 | Date 21/01/2019 |
| Token No | SM/18-19/7219 21/01/2019 | Serial | 087 Last Visit: 28/11/2025 |
| Patient Name | Mrs. ISITA ASH | Contact No | 9051743338 |
| Address | 14A DUTTS LANE | Age | 54 Years,10 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||