Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02472 | Date 12/12/2018 |
| Token No | SM/19-20/8503 16/08/2019 | Serial | 086 Last Visit: 15/11/2025 |
| Patient Name | Mr. JAYANTA ROY CHOWDHURY | Contact No | 9330629590 |
| Address | 8 B /1 M C LEHIRI STREET | Age | 71 Years,10 Months,30 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||