Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09750 | Date 24/06/2021 |
| Token No | SM/21-22/3565 27/07/2021 | Serial | 042 Last Visit: 26/11/2025 |
| Patient Name | Mr. SAMIR BOSE | Contact No | 943210748 |
| Address | 3,MALLIK PARA BYE LANE SERAMPORE | Age | 72 Years,10 Months,24 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||