Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00726 | Date 27/08/2018 |
| Token No | SM/21-22/8164 27/12/2021 | Serial | 056 Last Visit: 08/12/2025 |
| Patient Name | Mrs. MAYA RANA | Contact No | 7890210986 |
| Address | (GODER BAGAN), BAIDYABATI(M) | Age | 54 Years,11 Months,6 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||