Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00263 | Date 09/08/2018 |
| Token No | SM/21-22/2280 15/06/2021 | Serial | 016 Last Visit: 27/11/2025 |
| Patient Name | Mr. DULAL SIL | Contact No | 9874697072 |
| Address | 316 MILAN COLONY PIARAPUR J.K. SARKAR ROAD SHEORAPHULI | Age | 64 Years,10 Months,25 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||