Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00775 | Date 28/08/2018 |
| Token No | SM/22-23/17585 01/11/2022 | Serial | 013 Last Visit: 15/12/2025 |
| Patient Name | Mrs. DIPALI ASH | Contact No | 9836038633 |
| Address | 79 BARUI PARA CHATRA | Age | 55 Years,11 Months,13 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | 150 cm BMI: 20.000000 |
| Diagnosis | |||