Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05551 | Date 24/06/2019 |
| Token No | SM/21-22/7599 09/12/2021 | Serial | 014 Last Visit: 19/11/2025 |
| Patient Name | Mr. BHUTNATH GOPE | Contact No | 7890733398 |
| Address | 168 RAJYADHARPUR GOVT. KOLONI | Age | 52 Years,10 Months,17 Days Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||