Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02708 | Date 27/12/2018 |
| Token No | SM/22-23/17839 12/11/2022 | Serial | 042 Last Visit: 23/08/2025 |
| Patient Name | Mr. SHIBU CHANDRA DAS | Contact No | 8335911929 |
| Address | 44 KHAS BAGAN LANE | Age | 52 Years,1 Months,22 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||