Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01506 | Date 04/10/2018 |
| Token No | SM/18-19/2451 04/10/2018 | Serial | 049 Last Visit: 06/10/2018 |
| Patient Name | Mrs. NILU RANI GHOSH | Contact No | 9051755864 |
| Address | 75,MALLICKPARA SERAMPORE | Age | 50 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | 130/90 / min | Height | cm BMI: nan |
| Diagnosis | |||