Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04631 | Date 08/04/2019 |
| Token No | SM/19-20/5354 26/06/2019 | Serial | 018 Last Visit: 26/06/2019 |
| Patient Name | Mrs. MALA SHAW | Contact No | 9143231344 |
| Address | 281/B/A/1 NABAGRAM MALLICK PARA,BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||