Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02665 | Date 24/12/2018 |
| Token No | SM/19-20/8736 20/08/2019 | Serial | 015 Last Visit: 15/12/2022 |
| Patient Name | Mr. PULIN CH. PRAMANIK | Contact No | 8013509266 |
| Address | 12/5 RAMKRISNA ROAD,CHATRA,BAIDYABATI(M) | Age | 78 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||