Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06442 | Date 17/09/2019 |
| Token No | SM/19-20/11099 25/09/2019 | Serial | 041 Last Visit: 25/09/2019 |
| Patient Name | Mrs. JOSHANA BANERJEE | Contact No | |
| Address | 7 CHATRA GHOSH PARA 1ST LANE SERAMPORE | Age | 49 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||