Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03681 | Date 18/02/2019 |
| Token No | SM/19-20/7536 29/07/2019 | Serial | 072 Last Visit: 19/07/2025 |
| Patient Name | Mrs. DURGA HALDAR | Contact No | 9123967531 |
| Address | TELI PARA BAGER BAGAN CHATRA, BAIDYABATI(M) | Age | 24 Years,6 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||