Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05063 | Date 10/05/2019 |
| Token No | SM/19-20/2589 11/05/2019 | Serial | 077 Last Visit: 11/05/2019 |
| Patient Name | Mrs. SUPARNA BEGAM | Contact No | 6290439176 |
| Address | 15 CHATRA MUSALMAN PARA CHATUGANG, SERAMPORE | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||