Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04885 | Date 24/04/2019 |
| Token No | SM/19-20/13390 16/11/2019 | Serial | 050 Last Visit: 18/11/2019 |
| Patient Name | Mrs. RIMA RAY | Contact No | 9903958304 |
| Address | 160 N.S AVENUE SERAMPORE | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||