Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07201 | Date 20/12/2019 |
| Token No | SM/21-22/590 19/04/2021 | Serial | 057 Last Visit: 23/05/2022 |
| Patient Name | Mr. KRISHNA SHAW | Contact No | 9681465667 |
| Address | 57/J/E, G.T ROAD CHATRA PAMPANAGAR, BAIDYABATI(M) | Age | 46 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||