Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04019 | Date 05/03/2019 |
| Token No | SM/18-19/9899 05/03/2019 | Serial | 100 Last Visit: 05/03/2019 |
| Patient Name | Miss RAJIKA GHOSH | Contact No | 9874056826 |
| Address | 2A THAKURDAS BABU LANE | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||