Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00408 | Date 13/08/2018 |
| Token No | SM/19-20/5263 25/06/2019 | Serial | 019 Last Visit: 25/06/2019 |
| Patient Name | Mrs. MENOKA GHOSH | Contact No | 7278769134 |
| Address | MANNA PARA, CHATRA, BAIDYABATI M | Age | 58.0 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||