Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04036 | Date 06/03/2019 |
| Token No | SM/18-19/9969 06/03/2019 | Serial | 059 Last Visit: 06/03/2019 |
| Patient Name | Miss LIPIKA DUTTA | Contact No | 8420882518 |
| Address | 36/B CHATRA DUTTA PARA LANE | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||