Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08190 | Date 30/04/2020 |
| Token No | SM/19-20/23127 15/06/2020 | Serial | 049 Last Visit: 17/04/2025 |
| Patient Name | Mrs. BASANTI DAS | Contact No | 8902037550 |
| Address | 42 BARABAGAN LANE | Age | 55 Years,3 Months,14 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||