Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05988 | Date 29/07/2019 |
| Token No | SM/21-22/102 05/04/2021 | Serial | 015 Last Visit: 28/08/2023 |
| Patient Name | Mr. MODAN MOHAN PAL | Contact No | 9874719824 |
| Address | 13/A KUMOR PARA CHATRA SERAMPORE | Age | 63 Years,7 Months,26 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||