Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 15860 | Date 07/08/2025 |
| Token No | SM/25-26/4628 07/08/2025 | Serial | 032 Last Visit: 07/08/2025 |
| Patient Name | Mr. LAKSHMIKANTA DAKSHI | Contact No | 8820959155 |
| Address | 61/A CHATRA BARUI PARA LANE SERAMPORE | Age | 82 Years,2 Months,29 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||