Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10328 | Date 24/11/2021 |
| Token No | SM/21-22/7092 24/11/2021 | Serial | 009 Last Visit: 27/11/2025 |
| Patient Name | Mr. CHANCHAL KUMAR DUTTA | Contact No | 8420516714 |
| Address | 38/2CHATRA GT ROAD | Age | 60 Years,5 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||