Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06751 | Date 24/10/2019 |
| Token No | SM/19-20/12390 25/10/2019 | Serial | 006 Last Visit: 25/10/2019 |
| Patient Name | Mrs. SHRABONI DHARA | Contact No | 9007728530 |
| Address | 30/C BAHIR SERAMPORE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||