Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04031 | Date 06/03/2019 |
| Token No | SM/18-19/9956 06/03/2019 | Serial | 046 Last Visit: 06/03/2019 |
| Patient Name | Mr. DIPANKAR MITRA | Contact No | 8820318624 |
| Address | 52/C RAMKRISHNA ROAD CHATRA MANNA PARA SERAMPORE | Age | 8 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||