Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06675 | Date 17/10/2019 |
| Token No | SM/19-20/23982 10/07/2020 | Serial | 013 Last Visit: 10/07/2020 |
| Patient Name | Mr. ASHOK SAHA | Contact No | 8981329640 |
| Address | 122 CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 36 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||