Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06328 | Date 04/09/2019 |
| Token No | SM/19-20/9775 04/09/2019 | Serial | 006 Last Visit: 09/09/2023 |
| Patient Name | Mrs. SHARMILA DAS | Contact No | 9720503238 |
| Address | 51 SHITLATALA ROAD CHATRA , BAIDYABATI(M) | Age | 55 Years,8 Months,7 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||