Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06844 | Date 13/11/2019 |
| Token No | SM/19-20/13328 15/11/2019 | Serial | 061 Last Visit: 15/11/2019 |
| Patient Name | Mrs. PAYAL CHAKRABORTY | Contact No | 7278787629 |
| Address | 50 KUMIR JELA ROAD SERAMPORE | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||