Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08740 | Date 15/09/2020 |
| Token No | SM/21-22/9620 07/02/2022 | Serial | 010 Last Visit: 17/12/2025 |
| Patient Name | Mrs. SADHANA GUIN | Contact No | 9832124490 |
| Address | 11/A SHITALATALA ROAD CHATRA BAIDYABATI(M) | Age | 51 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||