Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04390 | Date 26/03/2019 |
| Token No | SM/18-19/11341 27/03/2019 | Serial | 045 Last Visit: 27/03/2019 |
| Patient Name | Mrs. SUMI RANI PAL | Contact No | 6290062416 |
| Address | 109A J.L GUPTA LANE BAIDYAPARA , BAIDYABATI(M) | Age | 32 yrs Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||