Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03795 | Date 22/02/2019 |
| Token No | SM/19-20/7259 25/07/2019 | Serial | 012 Last Visit: 25/03/2021 |
| Patient Name | Mr. JAYNTA KUMAR SAHA | Contact No | 9051069332 |
| Address | 12/A/1 GAILA PARA LANE | Age | 56 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||