Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00752 | Date 28/08/2018 |
| Token No | SM/20-21/28757 24/12/2020 | Serial | 040 Last Visit: 20/11/2025 |
| Patient Name | Mr. GOUTAM SETH | Contact No | 9883831015 |
| Address | 470/309 GT ROAD CHATRA BOU BAZAR , BAIDYABATI(M) | Age | 64 Years,3 Months,3 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||