Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06831 | Date 11/11/2019 |
| Token No | SM/19-20/25410 03/09/2020 | Serial | 056 Last Visit: 28/05/2025 |
| Patient Name | Mrs. SIKHA DAS | Contact No | 9330539520 |
| Address | 461 G.T ROAD BOWBAZAR , CHATRA BAIDYBATI(M) | Age | 70 Years,3 Months,0 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||