Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00377 | Date 13/08/2018 |
| Token No | SM/20-21/28013 02/12/2020 | Serial | 028 Last Visit: 22/12/2025 |
| Patient Name | Mr. KAMAL CHINYA | Contact No | 9674530065 |
| Address | 34, CHATRA BAZAR ROAD | Age | 76 Years,11 Months,20 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||