Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04504 | Date 02/04/2019 |
| Token No | SM/21-22/11074 25/03/2022 | Serial | 010 Last Visit: 13/09/2022 |
| Patient Name | Mrs. JHUNU GHOSH | Contact No | 8420906620 |
| Address | 60 CHATRA MANA PARA RAM KRISHNA ROAD , BAIDYABATI(M) | Age | 56 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||