Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02204 | Date 29/11/2018 |
| Token No | SM/20-21/25960 23/09/2020 | Serial | 004 Last Visit: 10/11/2025 |
| Patient Name | Mr. SHANKAR PAL | Contact No | 8609041975 |
| Address | 12D/3 ARBINDA SARANI CHATRA KUMAR PARA | Age | 48 Years,10 Months,8 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||