Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00077 | Date 03/08/2018 |
| Token No | SM/22-23/22454 27/06/2023 | Serial | 017 Last Visit: 28/05/2025 |
| Patient Name | Mrs. MOLY SOM | Contact No | |
| Address | 17, CHATRA DUTTA PARA | Age | 42 Years,4 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||