Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02514 | Date 13/12/2018 |
| Token No | SM/18-19/6964 17/01/2019 | Serial | 044 Last Visit: 04/06/2025 |
| Patient Name | Mr. CHANDAN DAS | Contact No | 9163693972 |
| Address | CHATRA LONKAR BAGAN | Age | 54 Years,5 Months,2 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||