Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05896 | Date 23/07/2019 |
| Token No | SM/22-23/14754 18/07/2022 | Serial | 045 Last Visit: 19/11/2025 |
| Patient Name | Mr. GOUR CHANDRA DAS | Contact No | 9874449059 |
| Address | 30/B DHARMATALA LANE CHATRA SERAMPORE | Age | 62 Years,10 Months,18 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||