Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10046 | Date 04/09/2021 |
| Token No | SM/21-22/4757 04/09/2021 | Serial | 026 Last Visit: 28/10/2025 |
| Patient Name | Mr. SUROJIT MONDAL | Contact No | 9163722970 |
| Address | 11/8 K. C. MUKHERJEE STREET,CHATRA,BAIDYABATI(M) | Age | 43 Years,9 Months,26 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||