Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00694 | Date 25/08/2018 |
| Token No | SM/19-20/25293 28/08/2020 | Serial | 047 Last Visit: 10/11/2025 |
| Patient Name | Mrs. CHHOBI BARIK | Contact No | 9007638200 |
| Address | 23, SATCHASI PARA CHATRA SERAMPORE | Age | 48 Years,10 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||