Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00434 | Date 14/08/2018 |
| Token No | SM/19-20/419 06/04/2019 | Serial | 047 Last Visit: 17/12/2025 |
| Patient Name | Mrs. RENUKA DAS | Contact No | 9477356052 |
| Address | LONKAR BAGAN, CHATRA | Age | 56 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||