Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01787 | Date 30/10/2018 |
| Token No | SM/18-19/3206 31/10/2018 | Serial | 010 Last Visit: 02/09/2019 |
| Patient Name | Mrs. TAPOSI NANDI | Contact No | 8478996717 |
| Address | 104/46 CHATRA LANKAR BAGAN BAIDYABATI (M) | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||