Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01004 | Date 08/09/2018 |
| Token No | SM/19-20/2686 13/05/2019 | Serial | 097 Last Visit: 12/08/2025 |
| Patient Name | Mr. ASOK KR DAS | Contact No | 9933624955 |
| Address | GOPALPUR | Age | 62 Years,7 Months,10 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||