Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08761 | Date 21/09/2020 |
| Token No | SM/22-23/19116 22/12/2022 | Serial | 006 Last Visit: 23/09/2025 |
| Patient Name | Mr. BIJOY DAS | Contact No | 9007310343 |
| Address | 43/1 SATCHASI PARA CHATRA SERAMPORE, BAIDYABATI(M) | Age | 50 Years,8 Months,22 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||