Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03973 | Date 02/03/2019 |
| Token No | SM/18-19/9768 02/03/2019 | Serial | 087 Last Visit: 02/03/2019 |
| Patient Name | Miss KOYEL MONDAL | Contact No | 9062406259 |
| Address | CHATRA GODAR BAGAN BYE LANE SERAMPORE | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||