Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00765 | Date 28/08/2018 |
| Token No | SM/18-19/1129 01/09/2018 | Serial | 003 Last Visit: 14/11/2019 |
| Patient Name | Mr. BISWANATH MONDAL | Contact No | 8583907269 |
| Address | 32 CHAKRABORTY LANE SERAMPORE | Age | 77 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||