Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00665 | Date 24/08/2018 |
| Token No | SM/19-20/9770 04/09/2019 | Serial | 001 Last Visit: 07/06/2024 |
| Patient Name | Mrs. SHYAMALI PAKRE | Contact No | 8420789912 |
| Address | BAGER BAGAN CHATAR | Age | 38 Years,5 Months,5 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||