Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 10965 | Date 26/04/2022 |
| Token No | SM/22-23/12300 10/05/2022 | Serial | 036 Last Visit: 03/12/2025 |
| Patient Name | Mrs. ASHA SADHUKHAN | Contact No | 6291507197 |
| Address | 110 142/1 G.T ROAD BAIDYABATI (M)SHEORAPHULI | Age | 52 Years,11 Months,1 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||