Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08504 | Date 08/07/2020 |
| Token No | SM/19-20/23892 08/07/2020 | Serial | 006 Last Visit: 08/07/2020 |
| Patient Name | Mr. AMAR CHANDA DALAL | Contact No | 9674138149 |
| Address | 39E SATISH CH GHOSH LANE | Age | 50 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||