Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10377 | Date 02/12/2021 |
| Token No | SM/21-22/7428 02/12/2021 | Serial | 040 Last Visit: 27/12/2021 |
| Patient Name | Mr. PRITAM SANYAL | Contact No | 9330648343 |
| Address | 39,G.T ROAD ,BAIDHYABATI | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||