Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05013 | Date 04/05/2019 |
| Token No | SM/19-20/3511 27/05/2019 | Serial | 067 Last Visit: 27/05/2019 |
| Patient Name | Mrs. SUSMITA SARKAR | Contact No | 8017789968 |
| Address | 3/2K.C. MUKHERJEE STREET | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 81 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||