Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09507 | Date 22/04/2021 |
| Token No | SM/21-22/9330 25/01/2022 | Serial | 035 Last Visit: 26/11/2025 |
| Patient Name | Mrs. KABITA DAS | Contact No | 9230213656 |
| Address | CHATRA MANNA PARA ,RAMKRISHNA ROAD,BAIDYABATI(M) | Age | 58 Years,10 Months,25 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||