Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07861 | Date 19/03/2020 |
| Token No | SM/20-21/27897 27/11/2020 | Serial | 053 Last Visit: 01/03/2021 |
| Patient Name | Mr. RAJU GHOSH | Contact No | 9339118246 |
| Address | 43/F CHATRA MUKHERJEE PARA , BARA BAGAN , SHIBTALA , BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||