Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05853 | Date 19/07/2019 |
| Token No | SM/19-20/6898 20/07/2019 | Serial | 001 Last Visit: 07/07/2025 |
| Patient Name | Mrs. PURNIMA BAG | Contact No | 9836764962 |
| Address | 77/1 CHATRA MANNA PARA,BAIDYABATI(M) | Age | 36 Years,6 Months,4 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||