Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03799 | Date 22/02/2019 |
| Token No | SM/18-19/9326 23/02/2019 | Serial | 012 Last Visit: 01/03/2019 |
| Patient Name | Mrs. ALOKA DAS | Contact No | 9163098867 |
| Address | PIYARAPUR SCHOOL MATH, BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||