Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07323 | Date 11/01/2020 |
| Token No | SM/21-22/2023 08/06/2021 | Serial | 025 Last Visit: 09/10/2025 |
| Patient Name | Mr. CHINMOY ADAK | Contact No | 9051271428 |
| Address | 13,DR BAGAN LANE (PART-20) SERANPORE | Age | 58 Years,9 Months,7 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||