Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07702 | Date 04/03/2020 |
| Token No | SM/19-20/19712 16/03/2020 | Serial | 036 Last Visit: 23/03/2020 |
| Patient Name | Mrs. CHAMPA PAL | Contact No | 7044575784 |
| Address | 1 A.P GHOSH ROAD CHATRA SERAMPORE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||