Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03191 | Date 25/01/2019 |
| Token No | SM/19-20/21222 16/04/2020 | Serial | 064 Last Visit: 11/10/2025 |
| Patient Name | Mr. MADHUSUDHAN GHOSH | Contact No | 8478918874 |
| Address | CHATRA BOUBAZAR | Age | 52 Years,9 Months,9 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||