Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06985 | Date 25/11/2019 |
| Token No | SM/19-20/13962 25/11/2019 | Serial | 071 Last Visit: 25/11/2019 |
| Patient Name | Miss SUJATA GHARA | Contact No | 9830759492 |
| Address | 29,A CHATRA MUKHERJEE PARA | Age | 9 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||