Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03138 | Date 22/01/2019 |
| Token No | SM/18-19/7325 24/01/2019 | Serial | 012 Last Visit: 25/01/2019 |
| Patient Name | Mrs. ANJALI GHOSAL | Contact No | |
| Address | SHEORAPHULY,CHATU GHANGE,BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||