Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05546 | Date 24/06/2019 |
| Token No | SM/20-21/26682 15/10/2020 | Serial | 025 Last Visit: 15/11/2025 |
| Patient Name | Mr. SUMANTAK MUKHERJEE | Contact No | 8479940366 |
| Address | 297 TELIPARA,CHATRA,BAIDYABATI(M) | Age | 36 Years,10 Months,13 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||