Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04540 | Date 04/04/2019 |
| Token No | SM/19-20/5395 26/06/2019 | Serial | 059 Last Visit: 15/11/2025 |
| Patient Name | Mrs. MANJURI DUTTA | Contact No | 9051355632 |
| Address | 125 BARUI PARA LANE CHATRA | Age | 50 Years,10 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||