Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00269 | Date 09/08/2018 |
| Token No | SM/18-19/4354 29/11/2018 | Serial | 015 Last Visit: 17/11/2025 |
| Patient Name | Mrs. GOURI GHOSH | Contact No | |
| Address | 84 A.P. GHOSH ROAD, CHATRA, SERAMPORE | Age | 61 Years,10 Months,16 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||