Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01818 | Date 01/11/2018 |
| Token No | SM/19-20/1936 30/04/2019 | Serial | 004 Last Visit: 27/11/2025 |
| Patient Name | Mrs. MITHU DAS | Contact No | 6291171865 |
| Address | 36 BHADURI PARA LANE | Age | 50 Years,10 Months,25 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||