Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00502 | Date 17/08/2018 |
| Token No | SM/18-19/2756 11/10/2018 | Serial | 019 Last Visit: 05/05/2025 |
| Patient Name | Mrs. PIYALI CHOWDHURY | Contact No | 8240786372 |
| Address | PARMAR ROAD BHADRAKALI, UTTARPARA | Age | 57 Years,4 Months,3 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||