Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03871 | Date 26/02/2019 |
| Token No | SM/21-22/6196 25/10/2021 | Serial | 018 Last Visit: 10/12/2025 |
| Patient Name | Mr. PANCHU GOPAL DUTTA | Contact No | 9830339711 |
| Address | 75/39J G. T. ROADCHATRA TENTULTALA BAIDYABATI(M) | Age | 82 Years,11 Months,8 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||