Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05194 | Date 22/05/2019 |
| Token No | SM/19-20/3177 22/05/2019 | Serial | 018 Last Visit: 04/09/2025 |
| Patient Name | Mr. NEMAI CHANDRA DAS | Contact No | 9153343770 |
| Address | 7 CHATRA CHOWDHURY PARA LANE FL NO-303 , SERAMPORE | Age | 73 Years,7 Months,2 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||