Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00940 | Date 06/09/2018 |
| Token No | SM/19-20/18295 18/02/2020 | Serial | 030 Last Visit: 27/08/2025 |
| Patient Name | Mr. JOYDIP SOM | Contact No | 9836074282 |
| Address | 17/D CHATRA DUTTA PARA LANE | Age | 16 Years,7 Months,28 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||