Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09729 | Date 18/06/2021 |
| Token No | SM/21-22/6019 18/10/2021 | Serial | 055 Last Visit: 08/08/2025 |
| Patient Name | Mr. SK ISAK ALI | Contact No | 9883801881 |
| Address | 127/A A.P GHOSH ROAD CHATRA SERAMPORE | Age | 68 Years,7 Months,5 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||