Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04152 | Date 11/03/2019 |
| Token No | SM/18-19/10343 11/03/2019 | Serial | 052 Last Visit: 03/07/2023 |
| Patient Name | Miss MOU BAIDYA | Contact No | 9836037270 |
| Address | 32/17 CHATRA GODAR BAGAN,BAIDYABATI(M) | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||