Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04540 | Date 04/04/2019 |
| Token No | SM/20-21/31158 25/03/2021 | Serial | 016 Last Visit: 15/11/2025 |
| Patient Name | Mrs. MANJURI DUTTA | Contact No | 9051355632 |
| Address | 125 BARUI PARA LANE CHATRA | Age | 50 Years,10 Months,10 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||