Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00423 | Date 14/08/2018 |
| Token No | SM/18-19/3851 19/11/2018 | Serial | 018 Last Visit: 27/02/2019 |
| Patient Name | Mrs. BASANTI CHATTARJEE | Contact No | 9830895360 |
| Address | 61, THAKURDAS BABU LANE | Age | 54 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||