Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10384 | Date 04/12/2021 |
| Token No | SM/21-22/7469 04/12/2021 | Serial | 021 Last Visit: 11/10/2025 |
| Patient Name | Mr. SURYA KANTA LAHA | Contact No | 8777791734 |
| Address | 59A/A,G.T ROAD GODAR BAGAN BYE LANE | Age | 31 Years,10 Months,2 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||