Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04388 | Date 26/03/2019 |
| Token No | SM/19-20/685 10/04/2019 | Serial | 051 Last Visit: 26/08/2019 |
| Patient Name | Mr. SHASHANKA DUTTA | Contact No | 9062628296 |
| Address | 55A SHITLATALA ROAD , BAIDYABATI(M) | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||