Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00568 | Date 20/08/2018 |
| Token No | SM/19-20/11214 27/09/2019 | Serial | 025 Last Visit: 13/12/2025 |
| Patient Name | Mrs. SANTI DUBEY | Contact No | 9062765469 |
| Address | 21 CHOWDHARY PARA DOLATALA | Age | 65 Years,11 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||