Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09864 | Date 23/07/2021 |
| Token No | SM/21-22/9138 19/01/2022 | Serial | 044 Last Visit: 08/12/2025 |
| Patient Name | Mrs. HENA MUKHERJEE | Contact No | 9038511644 |
| Address | 118,TELI PARA LANE CHATRA BAGER BAGAN SERAMPORE | Age | 58 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 | |||