Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08385 | Date 18/06/2020 |
| Token No | SM/19-20/23896 08/07/2020 | Serial | 010 Last Visit: 22/10/2022 |
| Patient Name | Mr. NAND KISHORE MALAKAR | Contact No | 7003901021 |
| Address | 178/1 B.M ROAD CHAMPDANI , CHAMPADANI (M) | Age | 61 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||