Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04419 | Date 27/03/2019 |
| Token No | SM/19-20/7873 05/08/2019 | Serial | 012 Last Visit: 25/09/2025 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 7278111442 |
| Address | CHATRA DHARMOTALA LANE | Age | 77 Years,8 Months,24 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||