Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00686 | Date 25/08/2018 |
| Token No | SM/19-20/17162 25/01/2020 | Serial | 005 Last Visit: 13/12/2025 |
| Patient Name | Mr. MOHAN BANERJEE | Contact No | 9007324722 |
| Address | 13,CHATRA DHARMATALA | Age | 57 Years,11 Months,11 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||