Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05064 | Date 10/05/2019 |
| Token No | SM/19-20/2549 11/05/2019 | Serial | 037 Last Visit: 24/05/2019 |
| Patient Name | Mrs. LAXMI DAS | Contact No | 9062082615 |
| Address | PAHALAMPUR , HOOGHLY | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||