Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00865 | Date 31/08/2018 |
| Token No | SM/20-21/27106 04/11/2020 | Serial | 003 Last Visit: 21/11/2025 |
| Patient Name | Mrs. CHANDRA SOM | Contact No | 8420911483 |
| Address | 17/B CHATRA DUTTA PARA | Age | 61 Years,9 Months,18 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||