Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00434 | Date 14/08/2018 |
| Token No | SM/22-23/11277 01/04/2022 | Serial | 018 Last Visit: 17/12/2025 |
| Patient Name | Mrs. RENUKA DAS | Contact No | 9477356052 |
| Address | LONKAR BAGAN, CHATRA | 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 | |||