Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08636 | Date 07/08/2020 |
| Token No | SM/21-22/9873 15/02/2022 | Serial | 004 Last Visit: 29/10/2025 |
| Patient Name | Mr. AMIYA KUMAR KAR | Contact No | 7003323956 |
| Address | 16/2/A, BARA BAGAN LANE SERAMPORE, MALLICKPARA | Age | 73 Years,9 Months,27 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||