Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00432 | Date 14/08/2018 |
| Token No | SM/19-20/11379 30/09/2019 | Serial | 052 Last Visit: 08/12/2025 |
| Patient Name | Mrs. CHHAYA DUTTA | Contact No | 8013361718 |
| Address | 16, DUTTA LANE | Age | 50 Years,11 Months,6 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||