Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03222 | Date 29/01/2019 |
| Token No | SM/18-19/7587 30/01/2019 | Serial | 017 Last Visit: 30/01/2019 |
| Patient Name | Mrs. RITA GHOSH | Contact No | 8013908900 |
| Address | 16, RAJA K.L GOSWAMI STREET SERAMPORE | Age | 51 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||