Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05487 | Date 20/06/2019 |
| Token No | SM/22-23/12932 26/05/2022 | Serial | 038 Last Visit: 05/08/2022 |
| Patient Name | Mrs. ARCHANA ADAK | Contact No | 9143002319 |
| Address | 93 A. P. GHOSH ROAD | Age | 56 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||