Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01171 | Date 15/09/2018 |
| Token No | SM/25-26/1919 28/05/2025 | Serial | 073 Last Visit: 28/05/2025 |
| Patient Name | Mrs. BINA DAS | Contact No | |
| Address | MARADAN PAMPA NAGAR, BAIDYABATI(M) | Age | 58 Years,4 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||