Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09859 | Date 22/07/2021 |
| Token No | SM/25-26/5591 02/09/2025 | Serial | 010 Last Visit: 02/09/2025 |
| Patient Name | Mr. SHAMBHU DAS | Contact No | 7890569925 |
| Address | PAHALAMPUR | Age | 58 Years,8 Months,1 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||