Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05255 | Date 27/05/2019 |
| Token No | SM/19-20/15827 24/12/2019 | Serial | 020 Last Visit: 13/09/2022 |
| Patient Name | Mrs. TAPASI DAS | Contact No | 6289183989 |
| Address | BYE SERAMPORE KALI TALA | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||