Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06470 | Date 19/09/2019 |
| Token No | SM/19-20/21697 29/04/2020 | Serial | 016 Last Visit: 29/04/2020 |
| Patient Name | Mrs. ALPANA DAS | Contact No | 8336863805 |
| Address | 114 GHOSAL PARA LANE , NABOGRAM BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||