Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01171 | Date 15/09/2018 |
| Token No | SM/18-19/8654 14/02/2019 | Serial | 019 Last Visit: 28/05/2025 |
| Patient Name | Mrs. BINA DAS | Contact No | |
| Address | MARADAN PAMPA NAGAR, BAIDYABATI(M) | Age | 58 Years,4 Months,25 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||