Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07244 | Date 28/12/2019 |
| Token No | SM/19-20/16496 10/01/2020 | Serial | 021 Last Visit: 19/05/2020 |
| Patient Name | Mrs. SULATA PAL | Contact No | 8274894294 |
| Address | PURUSOTTAMPUR, MOLLASIMLA, HOOGHLY | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||