Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01142 | Date 14/09/2018 |
| Token No | SM/20-21/29307 13/01/2021 | Serial | 030 Last Visit: 16/07/2025 |
| Patient Name | Mrs. MITHU DAS | Contact No | 9038485220 |
| Address | CHATRA SACHTASI PARA BAIDYABATI (M) | Age | 46 Years,6 Months,13 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||