Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02384 | Date 06/12/2018 |
| Token No | SM/19-20/24136 15/07/2020 | Serial | 012 Last Visit: 18/08/2025 |
| Patient Name | Mrs. MILI PAL | Contact No | 7685986880 |
| Address | CHATRA KUMAR PARA | Age | 44 Years,7 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||