Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06128 | Date 16/08/2019 |
| Token No | SM/19-20/8484 16/08/2019 | Serial | 067 Last Visit: 22/02/2025 |
| Patient Name | Mr. KANAI SOM | Contact No | 9836526908 |
| Address | 142/A BARUI PARA LANE | Age | 76 Years,1 Months,20 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||