Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06802 | Date 06/11/2019 |
| Token No | SM/19-20/12941 09/11/2019 | Serial | 019 Last Visit: 09/12/2019 |
| Patient Name | Mrs. SUKLA ADHIKARI | Contact No | 7059470315 |
| Address | 21 KUMIRJALA ROAD , SERAMPORE | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||