Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03135 | Date 22/01/2019 |
| Token No | SM/20-21/26921 22/10/2020 | Serial | 009 Last Visit: 18/10/2025 |
| Patient Name | Mr. SOUMOJIT DUTTA | Contact No | 8017449612 |
| Address | 54 CHATRA BARUI PARA | Age | 18 Years,9 Months,16 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||