Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03807 | Date 22/02/2019 |
| Token No | SM/18-19/10484 13/03/2019 | Serial | 011 Last Visit: 17/12/2025 |
| Patient Name | Mrs. SEFALI SAMANTA | Contact No | 9875331868 |
| Address | 65(20) MUKHERJEE PARA CHATRA , BAIDYABATI(M) | Age | 54 Years,11 Months,15 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||