Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00252 | Date 08/08/2018 |
| Token No | SM/21-22/10236 24/02/2022 | Serial | 039 Last Visit: 10/10/2025 |
| Patient Name | Mrs. KALPANA GOSWAMI | Contact No | 6291823920 |
| Address | CHOWDHURY PARA, DOLTALA, CHATRA | Age | 64 Years,9 Months,8 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||