Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09321 | Date 15/03/2021 |
| Token No | SM/21-22/2260 14/06/2021 | Serial | 052 Last Visit: 17/12/2025 |
| Patient Name | Mr. MOHAN DAS | Contact No | 9230213656 |
| Address | 76 SATCHASI PARA, CHATRA, BAIDYABATI(M) | Age | 75 Years,11 Months,15 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||