Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00161 | Date 06/08/2018 |
| Token No | SM/21-22/9324 25/01/2022 | Serial | 029 Last Visit: 13/12/2025 |
| Patient Name | Mr. HAROGOBINDO MODAK | Contact No | 9231894209 |
| Address | CHATRA BARUI PARA, SERAMPORE | Age | 49 Years,11 Months,11 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||