Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 08455 | Date 30/06/2020 |
| Token No | SM/21-22/7017 22/11/2021 | Serial | 057 Last Visit: 17/12/2025 |
| Patient Name | Mr. HARADHAN DAS | Contact No | 6291053875 |
| Address | 15NO G.T. ROAD KALITALA SERAMPORE M | Age | 53 Years,0 Months,4 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||