Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00276 | Date 09/08/2018 |
| Token No | SM/19-20/10182 11/09/2019 | Serial | 089 Last Visit: 08/12/2025 |
| Patient Name | Mr. AKASH RUI DAS | Contact No | 7890568570 |
| Address | 37, CHATRA DAS PARA HARI CHARAN ROAD, BAIDYABATI(M) | Age | 19 Years,2 Months,12 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||