Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06937 | Date 21/11/2019 |
| Token No | SM/19-20/19354 11/03/2020 | Serial | 017 Last Visit: 04/05/2020 |
| Patient Name | Mr. HARUN MALLICK | Contact No | 7890620367 |
| Address | DAKSHIN PARA SERAMPORE 3, BANGIHATI MALLICKPARA HOOGHLY | Age | 50 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||