Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05055 | Date 10/05/2019 |
| Token No | SM/21-22/8150 27/12/2021 | Serial | 042 Last Visit: 29/11/2025 |
| Patient Name | Mr. KASHINATH DAS | Contact No | 9903119259 |
| Address | 42/2 CHATRA SACHTASHI PARA LANKAR BAGAN , BAIDYABATI(M) | Age | 45 Years,10 Months,28 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||