Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01277 | Date 24/09/2018 |
| Token No | SM/18-19/1942 24/09/2018 | Serial | 001 Last Visit: 24/09/2018 |
| Patient Name | Mrs. BELA GHOSH | Contact No | |
| Address | PROVAHAS NEGAR | Age | 70 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||