Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00386 | Date 13/08/2018 |
| Token No | SM/18-19/9747 02/03/2019 | Serial | 066 Last Visit: 25/08/2025 |
| Patient Name | Mrs. SHUKLA GOSWAMI | Contact No | 9748568072 |
| Address | 31, THAKURDAS BABU LANE | Age | 52 Years,7 Months,22 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||