Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00344 | Date 11/08/2018 |
| Token No | SM/18-19/2030 25/09/2018 | Serial | 012 Last Visit: 04/12/2025 |
| Patient Name | Mrs. ASTAMI ADHIKARY | Contact No | 9836525799 |
| Address | 206A/A BAGER BAGAN, CHATRA | Age | 45 Years,2 Months,18 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||