Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02778 | Date 02/01/2019 |
| Token No | SM/19-20/8589 19/08/2019 | Serial | 043 Last Visit: 27/12/2025 |
| Patient Name | Mrs. KABITA RAY | Contact No | 9748202208 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI (M) | Age | 54 Years,11 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||