Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04864 | Date 23/04/2019 |
| Token No | SM/19-20/10242 12/09/2019 | Serial | 060 Last Visit: 10/01/2022 |
| Patient Name | Mr. ROHAN DAS | Contact No | 9903006594 |
| Address | 107AA CHATRA TETUL TALA, BAIDYABATI(M) | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||