Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09620 | Date 18/05/2021 |
| Token No | SM/22-23/17671 05/11/2022 | Serial | 013 Last Visit: 05/11/2022 |
| Patient Name | Mr. SURAJIT DAS | Contact No | 6289737223 |
| Address | 20 RAMKRISHNA BYE LANE, BAIDYABATI(M) | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||