Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09066 | Date 17/12/2020 |
| Token No | SM/20-21/28545 17/12/2020 | Serial | 051 Last Visit: 22/06/2021 |
| Patient Name | Mr. DIPANJAN DAS | Contact No | 9163198169 |
| Address | B2 301 PRABASNAGAR COLONY SERAMPORE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||