Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07366 | Date 18/01/2020 |
| Token No | SM/21-22/5198 18/09/2021 | Serial | 010 Last Visit: 28/10/2025 |
| Patient Name | Mr. DEBJIT MONDAL | Contact No | 9163722970 |
| Address | 11/8 CHATRA SHITLATALA , BAIDYABATI(M) | Age | 15 Years,4 Months,9 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||