Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01264 | Date 22/09/2018 |
| Token No | SM/18-19/1968 24/09/2018 | Serial | 027 Last Visit: 24/09/2018 |
| Patient Name | Mrs. MONGOLA CHATTERJEE | Contact No | 9874670309 |
| Address | 54/A DHARMA TALA LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||