Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09090 | Date 23/12/2020 |
| Token No | SM/21-22/856 26/04/2021 | Serial | 020 Last Visit: 17/12/2025 |
| Patient Name | Mrs. PADMA PATRA | Contact No | 7439050376 |
| Address | DAKSHIN RAJYADHARPUR (NATUN PARA) SDERAMPORE MALLICKPARA | Age | 56 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||