Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01771 | Date 30/10/2018 |
| Token No | SM/21-22/6096 22/10/2021 | Serial | 027 Last Visit: 08/09/2025 |
| Patient Name | Mrs. JAYEETA KUNDU | Contact No | 8479848931 |
| Address | CHATRA SAT CHASI PARA | Age | 32 Years,8 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||