Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04422 | Date 27/03/2019 |
| Token No | SM/21-22/6131 22/10/2021 | Serial | 062 Last Visit: 06/12/2022 |
| Patient Name | Mrs. SHANTI MANNA | Contact No | 8335863679 |
| Address | CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||