Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00395 | Date 13/08/2018 |
| Token No | SM/19-20/2898 17/05/2019 | Serial | 002 Last Visit: 17/12/2025 |
| Patient Name | Mrs. SHANTI NATH | Contact No | 9836594725 |
| Address | LONKARBAGAN CHATRA, BAIDYABATI M | Age | 62 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||