Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02575 | Date 18/12/2018 |
| Token No | SM/21-22/9304 25/01/2022 | Serial | 009 Last Visit: 18/12/2025 |
| Patient Name | Mr. JAYDEB GHORUI | Contact No | 9123880825 |
| Address | 27/B LEHIRI PARA LANE | Age | 49 Years,11 Months,16 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||