Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03504 | Date 12/02/2019 |
| Token No | SM/25-26/7825 10/11/2025 | Serial | 045 Last Visit: 22/12/2025 |
| Patient Name | Mr. SAMRAT CHATTERJEE | Contact No | 8584087471 |
| Address | 16 CHATRA CHOWDHURY PARA BYE LANE SERAMPORE | Age | 24 Years,11 Months,20 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||