Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 12026 | Date 06/04/2023 |
| Token No | SM/22-23/21128 12/04/2023 | Serial | 008 Last Visit: 16/07/2025 |
| Patient Name | Mr. SUSHANTA MOHANTI | Contact No | 9883175522 |
| Address | 24/A/1 CHATRA KUMAR PARA SERAMPORE | Age | 49 Years,1 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||