Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06181 | Date 21/08/2019 |
| Token No | SM/19-20/8958 22/08/2019 | Serial | 023 Last Visit: 26/08/2019 |
| Patient Name | Mrs. FALGUNI RAY | Contact No | 8274873068 |
| Address | 214 CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||