Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05199 | Date 22/05/2019 |
| Token No | SM/19-20/3225 22/05/2019 | Serial | 066 Last Visit: 24/06/2023 |
| Patient Name | Mrs. RAMA DAS | Contact No | |
| Address | 41/1 SATCHASI PARA, BAIDYABATI(M) | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||