Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06429 | Date 16/09/2019 |
| Token No | SM/19-20/10540 17/09/2019 | Serial | 031 Last Visit: 05/03/2021 |
| Patient Name | Mrs. RITA ACHARYA | Contact No | 9163514437 |
| Address | 366/147 GT ROAD CHATRA , BAIDYABATI | Age | 59 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||