Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08450 | Date 29/06/2020 |
| Token No | SM/21-22/8774 10/01/2022 | Serial | 056 Last Visit: 11/09/2025 |
| Patient Name | Mr. SK RAFIK | Contact No | 9748770251 |
| Address | 4/A MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 52 Years,8 Months,9 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||