Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06601 | Date 10/10/2019 |
| Token No | SM/19-20/11572 11/10/2019 | Serial | 020 Last Visit: 26/07/2021 |
| Patient Name | Mr. SOMNATH SAMANTA | Contact No | 7278128540 |
| Address | 31/1/1 GT ROAD , BAGER BAGAN, BAIDYABATI(M) | Age | 55 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||