Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04737 | Date 17/04/2019 |
| Token No | SM/21-22/7096 24/11/2021 | Serial | 013 Last Visit: 13/12/2025 |
| Patient Name | Mrs. MALI SOM | Contact No | 9874632694 |
| Address | 17 CHATRA DUTTA PARA LANE | Age | 44 Years,11 Months,11 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||