Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05411 | Date 13/06/2019 |
| Token No | SM/19-20/4548 14/06/2019 | Serial | 023 Last Visit: 14/06/2019 |
| Patient Name | Mrs. JHUMPA BIBI | Contact No | 7890279188 |
| Address | 31F MIYAJAN DARJI LANE SERAMPORE | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||