Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03620 | Date 16/02/2019 |
| Token No | SM/18-19/9929 06/03/2019 | Serial | 019 Last Visit: 06/03/2019 |
| Patient Name | Mr. SRIKANTA GHOSH | Contact No | 9830056558 |
| Address | GHORA MARA | Age | 45 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||