Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04612 | Date 08/04/2019 |
| Token No | SM/21-22/2482 23/06/2021 | Serial | 036 Last Visit: 13/11/2024 |
| Patient Name | Mrs. RINA CHAKRABORTY | Contact No | 9831917576 |
| Address | 28 CHATRA BAUBAZAR TELIPARA, BAIDYABATI(M) | Age | 55 Years,10 Months,11 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||