Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02616 | Date 20/12/2018 |
| Token No | SM/18-19/5562 21/12/2018 | Serial | 012 Last Visit: 27/12/2021 |
| Patient Name | Mr. BILWAMONGAL PAL | Contact No | 9830765732 |
| Address | CHATRA TETUL TALA,BAIDYABATI (M) | Age | 40YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||