Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11290 | Date 18/07/2022 |
| Token No | SM/22-23/14759 18/07/2022 | Serial | 050 Last Visit: 13/12/2025 |
| Patient Name | Mr. MOINAK DAS | Contact No | 9433818593 |
| Address | 42 BARABAGAN LANE, SERAMPORE | Age | 12 Years,1 Months,18 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||