Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00016 | Date 01/08/2018 |
| Token No | SM/21-22/3685 02/08/2021 | Serial | 031 Last Visit: 29/11/2025 |
| Patient Name | Mrs. MAMATA SAHU | Contact No | 8013504463 |
| Address | 2 BHATTACHARJEE PARA | Age | 29 Years,10 Months,28 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||