Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00772 | Date 28/08/2018 |
| Token No | SM/20-21/26312 05/10/2020 | Serial | 048 Last Visit: 13/12/2025 |
| Patient Name | Mrs. AMALA DEBI JADAB | Contact No | 6290359501 |
| Address | 2, CHOWDHURY PARA BYE LANE SERAMPORE | Age | 62 Years,11 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||