Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01321 | Date 25/09/2018 |
| Token No | SM/18-19/2073 26/09/2018 | Serial | 002 Last Visit: 04/10/2018 |
| Patient Name | Mrs. RUKSANA BIBI | Contact No | 8100063898 |
| Address | 5, PARSI LANE SERAMPORE HOOGHLY | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||