Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00469 | Date 16/08/2018 |
| Token No | SM/18-19/2217 29/09/2018 | Serial | 005 Last Visit: 27/11/2019 |
| Patient Name | Mrs. KAKALI BERA | Contact No | 7449344933 |
| Address | 12, JAGOMOHAN LAHIRI LANE, SERAMPORE | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||