Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10826 | Date 22/03/2022 |
| Token No | SM/22-23/11805 19/04/2022 | Serial | 032 Last Visit: 19/05/2022 |
| Patient Name | Mr. UDITANSHU POREL | Contact No | 9123317393 |
| Address | 13 NIL BAGAN LANE BAIDYABATI(M) | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||