Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08164 | Date 28/04/2020 |
| Token No | SM/19-20/21667 28/04/2020 | Serial | 016 Last Visit: 28/04/2020 |
| Patient Name | Mrs. MIMI PAL | Contact No | |
| Address | 102 PROVASNAGAR SERAMPORE | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||