Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04380 | Date 25/03/2019 |
| Token No | SM/19-20/59 01/04/2019 | Serial | 060 Last Visit: 05/04/2019 |
| Patient Name | Mrs. PUSPA DAS | Contact No | 9674481194 |
| Address | 11, A P.N MUKHERJEE STREET | Age | 75 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||