Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03727 | Date 20/02/2019 |
| Token No | SM/18-19/9100 20/02/2019 | Serial | 038 Last Visit: 14/11/2025 |
| Patient Name | Mrs. PURNIMA GHORUI | Contact No | 9874279546 |
| Address | CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 52 Years,10 Months,12 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||