Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09328 | Date 15/03/2021 |
| Token No | SM/20-21/30827 17/03/2021 | Serial | 006 Last Visit: 29/11/2025 |
| Patient Name | Mrs. JHUMA PORAY | Contact No | 8420208679 |
| Address | 22 DR. G. C. GOSWAMI STREET | Age | 41 Years,10 Months,28 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||