Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00004 | Date 01/08/2018 |
| Token No | SM/22-23/12809 23/05/2022 | Serial | 057 Last Visit: 31/12/2024 |
| Patient Name | Mrs. MALATI BAG | Contact No | 8622021520 |
| Address | TELIPARA PARA BAGER BAGAN BAIDYABATI(M) | Age | 57 Years,11 Months,29 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||