Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 16325 | Date 29/11/2025 |
| Token No | SM/25-26/8417 29/11/2025 | Serial | 007 Last Visit: 06/12/2025 |
| Patient Name | Mr. GOUTAM PAL | Contact No | 8584911101 |
| Address | 74/A RAMKRISHNA ROAD CHATRA BAIDYABATI (M) | Age | 54 Years,9 Months,27 Days Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||