Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09901 | Date 02/08/2021 |
| Token No | SM/21-22/3688 02/08/2021 | Serial | 034 Last Visit: 29/08/2025 |
| Patient Name | Mrs. BULBULI PATRA | Contact No | 8013954944 |
| Address | 18,G.T ROAD BAIDHYABATI | Age | 32 Years,2 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||