Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00754 | Date 28/08/2018 |
| Token No | SM/20-21/26454 08/10/2020 | Serial | 017 Last Visit: 10/09/2025 |
| Patient Name | Mrs. MAYA MANNA | Contact No | 8017971847 |
| Address | BAGER BAGAN TELI PARA | Age | 45 Years,8 Months,9 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||