Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05382 | Date 11/06/2019 |
| Token No | SM/19-20/20216 24/03/2020 | Serial | 037 Last Visit: 18/11/2022 |
| Patient Name | Mr. SUROJIT DAS | Contact No | 7059586137 |
| Address | 47/31 HARIJAN ROAD, BAIDYABATI(M) | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||