Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00548 | Date 18/08/2018 |
| Token No | SM/19-20/22500 27/05/2020 | Serial | 042 Last Visit: 17/12/2025 |
| Patient Name | Mr. SAMIR KR. CHAKRABORTY | Contact No | 9830590177 |
| Address | 25/A/3/1, KUMIRJOLA ROAD | Age | 81 Years,11 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||