Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03817 | Date 23/02/2019 |
| Token No | SM/19-20/21690 29/04/2020 | Serial | 009 Last Visit: 25/07/2025 |
| Patient Name | Mr. SAMEER DHARA | Contact No | 9674227128 |
| Address | 29/A DAKSHIN BHATTACHARYA PARA,BAIDYABATI(M) | Age | 39 Years,3 Months,27 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||