Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00347 | Date 11/08/2018 |
| Token No | SM/18-19/10711 18/03/2019 | Serial | 010 Last Visit: 12/02/2020 |
| Patient Name | Mr. MANICKLAL CHATTERJEE | Contact No | 8017781943 |
| Address | 11, JAGA MOHAN LAHIRI LANE | Age | 60 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||