Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03923 | Date 28/02/2019 |
| Token No | SM/18-19/9621 28/02/2019 | Serial | 043 Last Visit: 28/02/2019 |
| Patient Name | Miss PARAMA MUKHERJEE | Contact No | 9123775757 |
| Address | 112/A G T ROAD MARADAN,BAIDYABATI(M,) | Age | 9 Y 6 M Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||