Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00110 | Date 04/08/2018 |
| Token No | SM/18-19/853 25/08/2018 | Serial | 022 Last Visit: 11/07/2025 |
| Patient Name | Mrs. RINKU SOM | Contact No | 9836262602 |
| Address | 17/B CHATRA DUTTA PARA | Age | 51 Years,7 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||