Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06891 | Date 18/11/2019 |
| Token No | SM/19-20/14830 06/12/2019 | Serial | 087 Last Visit: 05/05/2020 |
| Patient Name | Mrs. BHARATI GHORUI | Contact No | 8420979068 |
| Address | 50 G.T ROAD CHATRA , BAIDYABATI(M) | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||