Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00631 | Date 23/08/2018 |
| Token No | SM/21-22/2301 16/06/2021 | Serial | 001 Last Visit: 13/12/2025 |
| Patient Name | Mrs. SUCHITRA MALICK | Contact No | 9163335285 |
| Address | PAMPA NAGAR , BAIDYABATI(M) | Age | 55 Years,11 Months,11 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||