Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01240 | Date 20/09/2018 |
| Token No | SM/18-19/1890 22/09/2018 | Serial | 003 Last Visit: 18/01/2022 |
| Patient Name | Mrs. BANI MUKHERJEE | Contact No | 9163792934 |
| Address | 91/A RAMKRISHNA ROAD, CHATRA MANNA PARA, BAIDYABATI, CHAMPDANY | Age | 74 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||