Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03970 | Date 02/03/2019 |
| Token No | SM/18-19/9763 02/03/2019 | Serial | 082 Last Visit: 02/03/2019 |
| Patient Name | Miss PRIYANKA DAS | Contact No | 9748928358 |
| Address | 20/D BARO BAGAN LANE SERAMPORE | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||