Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07740 | Date 11/03/2020 |
| Token No | SM/19-20/19350 11/03/2020 | Serial | 013 Last Visit: 19/11/2025 |
| Patient Name | Mr. JEET DAS | Contact No | 9051218237 |
| Address | 242 G.T ROAD CHATRA BAIDYABATI(M) | Age | 11 Years,10 Months,10 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||