Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03167 | Date 24/01/2019 |
| Token No | SM/19-20/20730 04/04/2020 | Serial | 011 Last Visit: 02/06/2023 |
| Patient Name | Mr. GORA CHAND DAS | Contact No | 9831886746 |
| Address | 10A BARO BAGAN LANE SERAMPORE | Age | 61 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||