Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00036 | Date 02/08/2018 |
| Token No | SM/19-20/13896 25/11/2019 | Serial | 005 Last Visit: 24/05/2025 |
| Patient Name | Mr. DIPTEN GHOSH | Contact No | 9903498148 |
| Address | 2 DUTTAPARA LANE, CHATRA | Age | 51 Years,4 Months,21 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||