Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00552 | Date 18/08/2018 |
| Token No | SM/22-23/12140 02/05/2022 | Serial | 016 Last Visit: 13/10/2025 |
| Patient Name | Mrs. SRABONI PAL | Contact No | 8420312039 |
| Address | 19, CHATRA BAJAR ROAD | Age | 42 Years,9 Months,11 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||