Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04851 | Date 23/04/2019 |
| Token No | SM/20-21/26525 12/10/2020 | Serial | 020 Last Visit: 19/09/2025 |
| Patient Name | Mrs. SANAKA ADAK | Contact No | 9903136933 |
| Address | BAHARAMPUR DHARAPARA, BAHARAMPUR, SINGUR | Age | 69 Years,8 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||