Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03663 | Date 18/02/2019 |
| Token No | SM/21-22/2680 29/06/2021 | Serial | 021 Last Visit: 18/09/2025 |
| Patient Name | Mrs. SOMA PAL | Contact No | 8013676535 |
| Address | 145/1 SHITALA TALA ROAD CHATRA , BAIDYABATI(M) | Age | 42 Years,8 Months,17 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||