Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09271 | Date 02/03/2021 |
| Token No | SM/20-21/30291 02/03/2021 | Serial | 054 Last Visit: 02/03/2021 |
| Patient Name | Mrs. BHARATI DUTTA | Contact No | 9804159159 |
| Address | 49/2 SITALA TALA ROAD BAIDYABATI (M) CHATRA | Age | 67 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||