Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09369 | Date 19/03/2021 |
| Token No | SM/20-21/30965 19/03/2021 | Serial | 074 Last Visit: 28/06/2025 |
| Patient Name | Mrs. DOLA DAS | Contact No | 8013658369 |
| Address | 243/89/1 TELIPARA LANE CHATRA BAIDYABATI(M) | Age | 41 Years,5 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||