Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02475 | Date 12/12/2018 |
| Token No | SM/18-19/5098 12/12/2018 | Serial | 012 Last Visit: 12/12/2018 |
| Patient Name | Mrs. RINA CHATTERJEE | Contact No | |
| Address | 24A/2 PROVASNAGAR | Age | 70 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||