Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03919 | Date 28/02/2019 |
| Token No | SM/18-19/9615 28/02/2019 | Serial | 037 Last Visit: 28/02/2019 |
| Patient Name | Miss RACHANA SARDER | Contact No | |
| Address | 126/6/A CHATRA BAGHER BAGAN,TELI PARA,BAIDYABATI(M) | Age | 12 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||