Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04541 | Date 04/04/2019 |
| Token No | SM/19-20/8655 19/08/2019 | Serial | 109 Last Visit: 13/12/2025 |
| Patient Name | Mrs. RUPA DAS | Contact No | 9674871505 |
| Address | 92 SATCHASI PARA , BAIDYABATI(M) | Age | 50 Years,11 Months,11 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||