Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08989 | Date 24/11/2020 |
| Token No | SM/21-22/2162 11/06/2021 | Serial | 028 Last Visit: 27/12/2025 |
| Patient Name | Mrs. TAPASII BAIDYA | Contact No | 9674175417 |
| Address | 78 BAGHER BAGAN,TELIPARA,BAIDYABATI(M) | Age | 52 Years,11 Months,25 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||