Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 15985 | Date 04/09/2025 |
| Token No | SM/25-26/5653 04/09/2025 | Serial | 003 Last Visit: 15/10/2025 |
| Patient Name | Mrs. PURNIMA RUIDAS | Contact No | 7439496132 |
| Address | 27 NO MUSALMANPARA ROAD | Age | 45 Years,9 Months,13 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||