Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00040 | Date 02/08/2018 |
| Token No | SM/19-20/11303 30/09/2019 | Serial | 028 Last Visit: 17/12/2025 |
| Patient Name | Mr. SAMBHUNATH PAL | Contact No | 9830045006 |
| Address | 36, CHATRA KUMARA PARA SERAMPORE | Age | 54 Years,11 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||