Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08889 | Date 17/10/2020 |
| Token No | SM/20-21/26778 17/10/2020 | Serial | 009 Last Visit: 28/06/2025 |
| Patient Name | Mrs. LAKSHMI DAS | Contact No | |
| Address | 118/0 TELIPARA BAIDYABATI (M) | Age | 54 Years,5 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||