Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10980 | Date 06/05/2022 |
| Token No | SM/22-23/12357 11/05/2022 | Serial | 019 Last Visit: 13/05/2022 |
| Patient Name | Mr. SOUMIK BAG | Contact No | 8100178377 |
| Address | BAIDYABATI CHAK,NOTUN PARA,BAIDYABATI(M) | Age | 24 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||