Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03868 | Date 26/02/2019 |
| Token No | SM/18-19/9523 27/02/2019 | Serial | 012 Last Visit: 12/03/2019 |
| Patient Name | Mrs. LALTI SHA | Contact No | 8334955542 |
| Address | L.B.S. ROAD SERAMPORE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||