Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03262 | Date 31/01/2019 |
| Token No | SM/19-20/18075 14/02/2020 | Serial | 032 Last Visit: 04/06/2021 |
| Patient Name | Master SOURAV DAS | Contact No | 8617269014 |
| Address | 20(11) KALI TALA LANE CHATRA , BAIDYABATI(M) | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||