Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10589 | Date 20/01/2022 |
| Token No | SM/21-22/9243 22/01/2022 | Serial | 010 Last Visit: 22/01/2022 |
| Patient Name | Mrs. KALPANA SAMANTA | Contact No | |
| Address | CHATRA BAGHER BAGAN,BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||