Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09220 | Date 28/01/2021 |
| Token No | SM/21-22/122 05/04/2021 | Serial | 035 Last Visit: 23/09/2025 |
| Patient Name | Mr. ROHAN DAS | Contact No | 6291458032 |
| Address | 43/1 SATCHASI PARA CHATRA , BAIDYABATI(M) | Age | 12 Years,8 Months,21 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||