Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10831 | Date 23/03/2022 |
| Token No | SM/21-22/11100 26/03/2022 | Serial | 011 Last Visit: 04/05/2022 |
| Patient Name | Mrs. BHARATI PATRA | Contact No | 9830589164 |
| Address | 22/1 J.N SEN STREET BAIDYABATI (M) | Age | 49 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||