Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 15143 | Date 18/03/2025 |
| Token No | SM/24-25/44003 18/03/2025 | Serial | 012 Last Visit: 25/08/2025 |
| Patient Name | Mrs. MOUSUMI ANKUR | Contact No | 7980701476 |
| Address | 130 GT ROAD CHATRA , BAIDYABATI (M) | Age | 24 Years,11 Months,15 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | 109/62 mmHg | Weight | 34.1 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||