Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03985 | Date 02/03/2019 |
| Token No | SM/18-19/9798 02/03/2019 | Serial | 117 Last Visit: 02/03/2019 |
| Patient Name | Miss PUNAM BISWAS | Contact No | 7890150382 |
| Address | CHATRA TETUL TALA, BAIDYABATI(M) | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||