Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02042 | Date 19/11/2018 |
| Token No | SM/18-19/3932 20/11/2018 | Serial | 010 Last Visit: 24/11/2018 |
| Patient Name | Mrs. RITUPARNA DAS | Contact No | 9875505021 |
| Address | 23, ROY GHAT LANE SERAMPORE | Age | 22 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||