Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00257 | Date 09/08/2018 |
| Token No | SM/18-19/5308 15/12/2018 | Serial | 040 Last Visit: 21/02/2025 |
| Patient Name | Mr. GOUTAM DAS | Contact No | 9106296772 |
| Address | 17, P.N.K BANERJEE LANE, CHATRA | Age | 44 Years,1 Months,20 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||