Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10109 | Date 22/09/2021 |
| Token No | SM/21-22/5339 22/09/2021 | Serial | 015 Last Visit: 28/07/2022 |
| Patient Name | Mr. DEBRAJ CHAKRABORTI | Contact No | 8697215560 |
| Address | 6 P. N. CHAKRABORTY LANE | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||