Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00782 | Date 28/08/2018 |
| Token No | SM/19-20/6972 20/07/2019 | Serial | 075 Last Visit: 14/11/2025 |
| Patient Name | Mrs. NILIMA DAS | Contact No | 8017570305 |
| Address | 10/C DUTTA PARA LANE CHATRA | Age | 29 Years,10 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||