Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00474 | Date 16/08/2018 |
| Token No | SM/21-22/2889 06/07/2021 | Serial | 019 Last Visit: 18/12/2025 |
| Patient Name | Mr. CHINMOY SOM | Contact No | 9836074282 |
| Address | 17D, CHATRA DUTTA PARA LANE | Age | 59 Years,3 Months,14 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||