Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01772 | Date 30/10/2018 |
| Token No | SM/18-19/11408 28/03/2019 | Serial | 010 Last Visit: 13/04/2019 |
| Patient Name | Mrs. HIRA DUTTA | Contact No | 8017172804 |
| Address | 87/82 CHATRA SHITLATALA, BAIDYABATI (M) | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||