Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03983 | Date 02/03/2019 |
| Token No | SM/18-19/9796 02/03/2019 | Serial | 115 Last Visit: 02/03/2019 |
| Patient Name | Miss ANANYA CHAKRABORTY | Contact No | 9735545072 |
| Address | NC CHAKRABORTY LANE | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||