Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05054 | Date 10/05/2019 |
| Token No | SM/21-22/8802 10/01/2022 | Serial | 084 Last Visit: 11/10/2025 |
| Patient Name | Mrs. TUMPA DAS | Contact No | 9903119259 |
| Address | CHATRA SACHTASHI PARA LANKAR BAGAN , BAIDYABATI(M) | Age | 45 Years,9 Months,9 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||