Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03963 | Date 02/03/2019 |
| Token No | SM/19-20/4159 08/06/2019 | Serial | 007 Last Visit: 22/09/2023 |
| Patient Name | Mr. PRITAM MANNA | Contact No | 8961497021 |
| Address | 176/73/E/5 CHATRA TELIPARA BAGHER BAGAN, BAIDYABATI(M) | Age | 15 Years,7 Months,15 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||