Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07524 | Date 12/02/2020 |
| Token No | SM/20-21/25892 21/09/2020 | Serial | 042 Last Visit: 11/08/2025 |
| Patient Name | Mrs. SUNITA DAS | Contact No | 7890952242 |
| Address | CHOTO BELU BELUMILKI | Age | 38 Years,7 Months,9 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||