Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08579 | Date 22/07/2020 |
| Token No | SM/22-23/11391 04/04/2022 | Serial | 065 Last Visit: 04/04/2022 |
| Patient Name | Mrs. MANASHI SOM | Contact No | 9433333765 |
| Address | 17/A DUTTA PARA LANE | Age | 47 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||