Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04507 | Date 02/04/2019 |
| Token No | SM/20-21/27028 02/11/2020 | Serial | 023 Last Visit: 18/07/2025 |
| Patient Name | Mrs. MINA MONDAL | Contact No | 9830831386 |
| Address | 102 GT ROAD CHATRA, BAIDYABATI(M) | Age | 54 Years,6 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||