Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 15719 | Date 19/07/2025 |
| Token No | SM/25-26/3839 19/07/2025 | Serial | 053 Last Visit: 12/09/2025 |
| Patient Name | Mrs. SUNITA RUIDAS | Contact No | 9231765975 |
| Address | 243 TELI PARA CHATRA BAIDYABATI (M) | Age | 27 Years,2 Months,20 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52.7 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||