Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05528 | Date 22/06/2019 |
| Token No | SM/19-20/5147 24/06/2019 | Serial | 013 Last Visit: 24/06/2019 |
| Patient Name | Mrs. RENU BALA DAS | Contact No | 9330987929 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI(M) | Age | 85 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||