Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03275 | Date 01/02/2019 |
| Token No | SM/19-20/10072 09/09/2019 | Serial | 076 Last Visit: 18/08/2025 |
| Patient Name | Mrs. RUPA DAS | Contact No | 9239358714 |
| Address | 48 SATCHASI PARA CHATRA SERAMPORE | Age | 63 Years,7 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||