Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00158 | Date 06/08/2018 |
| Token No | SM/25-26/14483 29/08/2026 at 10:33 | Serial | 022 Last Visit: 22/08/2026 |
| Patient Name | Mrs. PADMABATI MODAK | Contact No | 8100837190 |
| Address | 134/A BARUI PARA LANE , CHATRA | Age | 76 Years,7 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | 144.1 cm BMI: 21.189695 |
| Diagnosis | |||