Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 14641 | Date 04/12/2024 |
| Token No | SM/24-25/40274 05/12/2024 | Serial | 006 Last Visit: 16/10/2025 |
| Patient Name | Mrs. DEBRANI MAJHI | Contact No | 8759991614 |
| Address | 23 BENIYA PARA LANE SERAMPORE | Age | 65 Years,8 Months,14 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||