Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03012 | Date 15/01/2019 |
| Token No | SM/21-22/1167 05/05/2021 | Serial | 026 Last Visit: 28/11/2022 |
| Patient Name | Mrs. ANGURBALA SADHUKHAN | Contact No | 9681065397 |
| Address | 3 DHARMATALA LANE, CHATRA | Age | 78 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||