Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01766 | Date 29/10/2018 |
| Token No | SM/22-23/30042 07/03/2024 | Serial | 054 Last Visit: 18/10/2025 |
| Patient Name | Mrs. RITA RAHA | Contact No | 7044976067 |
| Address | 134/B CHATRA BARUI PARA SHIBTALA | Age | 49 Years,9 Months,16 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||