Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07416 | Date 25/01/2020 |
| Token No | SM/19-20/17305 27/01/2020 | Serial | 100 Last Visit: 03/04/2020 |
| Patient Name | Mrs. SWARNALATA DAS | Contact No | 9830636202 |
| Address | 47 (32) SHITALATALA ROAD , BAIDYABATI(M) | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||