Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03930 | Date 01/03/2019 |
| Token No | SM/18-19/9790 02/03/2019 | Serial | 109 Last Visit: 02/03/2019 |
| Patient Name | Miss SOUMI KARMOKAR | Contact No | 9830350959 |
| Address | CHATRA SHITLATALA GURUDAS BHATTCHARJEE LANE , BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||