Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06507 | Date 23/09/2019 |
| Token No | SM/19-20/10932 23/09/2019 | Serial | 059 Last Visit: 23/09/2019 |
| Patient Name | Mrs. SHAILO DAS | Contact No | |
| Address | SERAMPORE | Age | 80 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||