Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09772 | Date 30/06/2021 |
| Token No | SM/21-22/2703 30/06/2021 | Serial | 009 Last Visit: 10/08/2022 |
| Patient Name | Master SHUBHAM PAL | Contact No | 8479962268 |
| Address | 97 A.B GARDEN BAIDHYABATI | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||