Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03078 | Date 18/01/2019 |
| Token No | SM/21-22/6236 25/10/2021 | Serial | 058 Last Visit: 26/11/2025 |
| Patient Name | Mrs. TAPASHI DAS | Contact No | 8585878254 |
| Address | CHATRA SIDESWARI LANE | Age | 52 Years,10 Months,24 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||