Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08044 | Date 08/04/2020 |
| Token No | SM/20-21/27679 23/11/2020 | Serial | 047 Last Visit: 16/08/2025 |
| Patient Name | Mr. SHYAMAL DAS | Contact No | 9681213181 |
| Address | G. T. ROAD TELIPARA BAGER BAGAN BAIDYABATI M | Age | 45 Years,8 Months,12 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||