Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00614 | Date 21/08/2018 |
| Token No | SM/21-22/9911 15/02/2022 | Serial | 042 Last Visit: 19/02/2025 |
| Patient Name | Mrs. MAMONI HALDAR | Contact No | 8017389491 |
| Address | BAGER BAGAN TELI PARA, BAIDYABATI(M) | Age | 42 Years,1 Months,19 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||