Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01404 | Date 28/09/2018 |
| Token No | SM/19-20/23159 16/06/2020 | Serial | 030 Last Visit: 18/01/2022 |
| Patient Name | Mrs. SMRITI SAHA | Contact No | 9088722488 |
| Address | 12A/1 GAILA PARA LANE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||