Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03562 | Date 13/02/2019 |
| Token No | SM/19-20/12567 01/11/2019 | Serial | 014 Last Visit: 26/11/2025 |
| Patient Name | Mr. MODAN BENERJEE | Contact No | 9163100344 |
| Address | 13 CHATRA DHARMATALA LANE, SERAMPORE | Age | 64 Years,10 Months,24 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||