Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09289 | Date 05/03/2021 |
| Token No | SM/20-21/30655 12/03/2021 | Serial | 049 Last Visit: 29/11/2025 |
| Patient Name | Mrs. TARA KARAK | Contact No | 9007960741 |
| Address | 127/121 RAMKRISHNA ROAD,BAIDYABATI(M) | Age | 65 Years,10 Months,28 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||