Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00075 | Date 03/08/2018 |
| Token No | SM/21-22/9923 16/02/2022 | Serial | 009 Last Visit: 27/09/2025 |
| Patient Name | Mrs. SWAPNA PAUL | Contact No | 9830045006 |
| Address | 36, CHATARA KUMAR PARA | Age | 41 Years,8 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||