Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06465 | Date 19/09/2019 |
| Token No | SM/19-20/11172 26/09/2019 | Serial | 056 Last Visit: 30/12/2021 |
| Patient Name | Mrs. SIMA DAS | Contact No | 9330573653 |
| Address | NABOGRAM SADOGH PARA ,BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||