Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06129 | Date 16/08/2019 |
| Token No | SM/19-20/8485 16/08/2019 | Serial | 068 Last Visit: 18/09/2025 |
| Patient Name | Mr. BRIJ BIHARI CHOWDHURY | Contact No | 7890213390 |
| Address | 30/T/1 TELIPARA BAGER BAGAN , BAIDYABATI(M) | Age | 50 Years,8 Months,17 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||