Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11190 | Date 25/06/2022 |
| Token No | SM/22-23/14031 25/06/2022 | Serial | 035 Last Visit: 25/06/2022 |
| Patient Name | Mr. SURJA ACHARJO | Contact No | 7257896252 |
| Address | BARA BAGAN LANE SERAMPORE | Age | 18 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||