Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03981 | Date 02/03/2019 |
| Token No | SM/18-19/9793 02/03/2019 | Serial | 112 Last Visit: 02/03/2019 |
| Patient Name | Miss SWARNALI SARDAR | Contact No | 9163900876 |
| Address | CHATRA PATTI PARA, BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||