Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06777 | Date 01/11/2019 |
| Token No | SM/19-20/13841 23/11/2019 | Serial | 036 Last Visit: 03/09/2020 |
| Patient Name | Mrs. LAKSHMI KARAK | Contact No | 9836066475 |
| Address | 528/27G TELIPARA CHATRA , BAIDYABATI(M) | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||