Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05791 | Date 15/07/2019 |
| Token No | SM/21-22/1997 07/06/2021 | Serial | 036 Last Visit: 11/01/2025 |
| Patient Name | Mr. SAMBHU DAS | Contact No | |
| Address | 20/D BARA BAGAN | Age | 60 Years,0 Months,10 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||