Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00078 | Date 03/08/2018 |
| Token No | SM/21-22/3050 09/07/2021 | Serial | 030 Last Visit: 11/07/2025 |
| Patient Name | Mrs. CHHALANA PAL | Contact No | 7685802970 |
| Address | 54/A CHATRA DUTTA PARA | Age | 64 Years,6 Months,8 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||