Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00871 | Date 01/09/2018 |
| Token No | SM/19-20/10839 21/09/2019 | Serial | 048 Last Visit: 13/12/2025 |
| Patient Name | Mrs. GITA DAS | Contact No | 8777693276 |
| Address | 3B SIDESWARI TALA | Age | 81 Years,11 Months,11 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||