Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01776 | Date 30/10/2018 |
| Token No | SM/19-20/2165 04/05/2019 | Serial | 025 Last Visit: 28/11/2025 |
| Patient Name | Mr. SUDIPTA PAL | Contact No | 9836125866 |
| Address | 51 DHARMOTALA LANE CHATRA SERAMPORE | Age | 60 Years,10 Months,26 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||