Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03318 | Date 02/02/2019 |
| Token No | SM/20-21/26870 19/10/2020 | Serial | 081 Last Visit: 08/11/2025 |
| Patient Name | Mrs. SAMA DAS | Contact No | 7595918134 |
| Address | BHADURI PARA,CHATRA | Age | 79 Years,10 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||