Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00864 | Date 31/08/2018 |
| Token No | SM/22-23/25333 13/10/2023 | Serial | 026 Last Visit: 03/12/2025 |
| Patient Name | Mrs. ALPONA SOM | Contact No | 9051868267 |
| Address | 123/A CHATRA BARUI PARA LANE | Age | 49 Years,11 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||