Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08476 | Date 03/07/2020 |
| Token No | SM/19-20/23717 03/07/2020 | Serial | 040 Last Visit: 21/11/2025 |
| Patient Name | Mr. BABLU DAS | Contact No | |
| Address | 301/T/N TELIPARA BAGER BAGAN, BAIDYABATI(M) | Age | 36 Years,10 Months,19 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||