Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03122 | Date 21/01/2019 |
| Token No | SM/19-20/4279 10/06/2019 | Serial | 061 Last Visit: 05/06/2025 |
| Patient Name | Mrs. SANDHA DAS | Contact No | 8420336639 |
| Address | CHATRA BAGER BAGAN , BAIDYABATI (M) | Age | 54 Years,5 Months,3 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||