Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03248 | Date 31/01/2019 |
| Token No | SM/19-20/165 03/04/2019 | Serial | 020 Last Visit: 12/02/2020 |
| Patient Name | Mrs. MOUSUMI PAUL | Contact No | 7595979985 |
| Address | CHATRA,TETUL TALA BAZER,BAIDYABATI(M) | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||