Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01792 | Date 31/10/2018 |
| Token No | SM/21-22/6995 22/11/2021 | Serial | 035 Last Visit: 26/09/2025 |
| Patient Name | Mrs. SUNDARI DUTTA | Contact No | 8420545647 |
| Address | 17 B CHATRA, CHAPATALA | Age | 53 Years,8 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||