Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10131 | Date 25/09/2021 |
| Token No | SM/21-22/8205 28/12/2021 | Serial | 028 Last Visit: 03/03/2025 |
| Patient Name | Mrs. SUMITRA SHEE | Contact No | 6289113631 |
| Address | MAHISHYA PARA CHOTOBELU BELUMILKI | Age | 49 Years,2 Months,0 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||