Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07949 | Date 28/03/2020 |
| Token No | SM/19-20/20466 30/03/2020 | Serial | 017 Last Visit: 31/03/2020 |
| Patient Name | Mrs. KHIROTI BORMON | Contact No | 9933907012 |
| Address | 73/4 G. T . ROAD,CHATRA,BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||