Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09294 | Date 06/03/2021 |
| Token No | SM/21-22/5181 17/09/2021 | Serial | 004 Last Visit: 13/09/2025 |
| Patient Name | Mr. SUMAN BANIK | Contact No | 9903160522 |
| Address | 230/2 G T ROAD SHEORAPHULI, BAIDYABATI(M) | Age | 18 Years,8 Months,12 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||