Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03579 | Date 14/02/2019 |
| Token No | SM/19-20/2334 08/05/2019 | Serial | 025 Last Visit: 29/11/2025 |
| Patient Name | Mrs. MANIKA GHOSH | Contact No | 8697362092 |
| Address | 10/C CHATRA CHAPA TALA LANE | Age | 71 Years,10 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||