Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06866 | Date 14/11/2019 |
| Token No | SM/21-22/3196 15/07/2021 | Serial | 026 Last Visit: 18/12/2025 |
| Patient Name | Mr. DEBENDRA NATH | Contact No | 9674452084 |
| Address | 421/6, G.T ROAD, CHATRA SERAMPORE, BAIDYABATI(M) | Age | 59 Years,11 Months,16 Days Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||