Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00653 | Date 23/08/2018 |
| Token No | SM/19-20/25115 24/08/2020 | Serial | 057 Last Visit: 17/12/2025 |
| Patient Name | Mrs. LATIKA DALAL | Contact No | 8697339708 |
| Address | 82, BARUI PARA CHATRA | Age | 56 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||