Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05251 | Date 27/05/2019 |
| Token No | SM/19-20/13496 18/11/2019 | Serial | 071 Last Visit: 26/07/2025 |
| Patient Name | Mr. DEBJIT DAS | Contact No | 9903119259 |
| Address | 184/2 SATCHASI PARA LANKAR BAGAN , BAIDYABATI(M) | Age | 16 Years,10 Months,12 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||