Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10337 | Date 25/11/2021 |
| Token No | SM/21-22/7156 25/11/2021 | Serial | 020 Last Visit: 25/11/2021 |
| Patient Name | Mr. AVIRAJ CHAUDHURY | Contact No | 8584920988 |
| Address | 40/A CHATRA MUKHERJEE PARA,BAIDYABATI(M) | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||