Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04367 | Date 25/03/2019 |
| Token No | SM/18-19/11140 25/03/2019 | Serial | 060 Last Visit: 25/03/2019 |
| Patient Name | Mr. DEEP MITRA | Contact No | 8820318624 |
| Address | 52C RAMKRISHNA ROAD CHATRA MANNA PARA | Age | 11 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||