Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02450 | Date 10/12/2018 |
| Token No | SM/21-22/6582 03/11/2021 | Serial | 031 Last Visit: 17/12/2025 |
| Patient Name | Mrs. SANAKA MONDAL | Contact No | 8820394411 |
| Address | M C LEHIRI STREET | Age | 57 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||