Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04035 | Date 06/03/2019 |
| Token No | SM/18-19/9968 06/03/2019 | Serial | 058 Last Visit: 06/03/2019 |
| Patient Name | Miss SAYANTIKA KAR | Contact No | |
| Address | CHATRA KAJIPARA SERAMPORE | Age | 16 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||