Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05237 | Date 27/05/2019 |
| Token No | SM/19-20/23572 30/06/2020 | Serial | 025 Last Visit: 17/11/2025 |
| Patient Name | Mr. RATAN DAS | Contact No | 7044246039 |
| Address | 125, A.P GHOSH ROAD SERAMPORE | Age | 75 Years,10 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||