Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13122 | Date 15/01/2024 |
| Token No | SM/24-25/36076 16/08/2024 | Serial | 026 Last Visit: 22/12/2025 |
| Patient Name | Mr. SUMAN GHOSH | Contact No | 8172077808 |
| Address | ASTAI PURBA BURDAMAN | Age | 27 Years,11 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||