Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00166 | Date 06/08/2018 |
| Token No | SM/19-20/3602 28/05/2019 | Serial | 043 Last Visit: 17/12/2025 |
| Patient Name | Mrs. JAMUNA PARUI | Contact No | 9062335537 |
| Address | CHATRA LANKAR BAGAN | Age | 57 Years,11 Months,15 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||