Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10225 | Date 25/10/2021 |
| Token No | SM/21-22/6365 28/10/2021 | Serial | 031 Last Visit: 28/10/2021 |
| Patient Name | Mrs. SABITRI MONDAL | Contact No | 9681284921 |
| Address | MANIK GHOSHER BAGAN BAIDHYABATI | Age | 45 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||