Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01036 | Date 11/09/2018 |
| Token No | SM/18-19/1546 12/09/2018 | Serial | 012 Last Visit: 01/07/2025 |
| Patient Name | Mrs. MOUMITA PRAMANIK | Contact No | 7890397874 |
| Address | CHATRA SHITLATALA | Age | 25 Years,6 Months,29 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||