Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09606 | Date 11/05/2021 |
| Token No | SM/21-22/1314 11/05/2021 | Serial | 032 Last Visit: 29/10/2025 |
| Patient Name | Mrs. JYOTSNA HAPAR | Contact No | 8582880281 |
| Address | CHATRA TELI PARA BAGER BAGAN, BAIDYABATI(M) | Age | 50 Years,9 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||