Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05211 | Date 23/05/2019 |
| Token No | SM/20-21/28652 21/12/2020 | Serial | 045 Last Visit: 08/11/2025 |
| Patient Name | Mrs. TUSHI DAS | Contact No | 8697161183 |
| Address | CHATRA PATTI PARA BAIDYABATI(M) | Age | 44 Years,10 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||