Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08149 | Date 25/04/2020 |
| Token No | SM/19-20/21566 25/04/2020 | Serial | 018 Last Visit: 24/02/2025 |
| Patient Name | Mrs. SIMA DAS DOLUI | Contact No | 7686829802 |
| Address | 92/39 CHATRA, SHITALA TALA,BAIDYABATI(M) | Age | 27 Years,7 Months,29 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||