Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00207 | Date 07/08/2018 |
| Token No | SM/21-22/6011 18/10/2021 | Serial | 047 Last Visit: 28/11/2025 |
| Patient Name | Mrs. CHAMPA SADHUKHAN | Contact No | 9681065397 |
| Address | 3 DHARMOTALA LANE CHATRA | Age | 46 Years,10 Months,27 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||