Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00562 | Date 20/08/2018 |
| Token No | SM/18-19/5964 29/12/2018 | Serial | 019 Last Visit: 14/01/2021 |
| Patient Name | Mrs. DURGA DAS | Contact No | 8609081787 |
| Address | 20/11 CHATRA SHITLATALA , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||