Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07354 | Date 17/01/2020 |
| Token No | SM/19-20/17124 24/01/2020 | Serial | 039 Last Visit: 24/01/2020 |
| Patient Name | Mrs. RIYA SAHA | Contact No | 9433392573 |
| Address | 67/S G.T ROAD (WEST) VTC: SERAMPORE (M), P.O. MALLICK PARA | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||