Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 03730 | Date 20/02/2019 |
| Token No | SM/19-20/25203 26/08/2020 | Serial | 013 Last Visit: 26/08/2020 |
| Patient Name | Mrs. SHANKARI DAS | Contact No | |
| Address | 44/B GANGULY BAGAN LANE MAHESH | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||