Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05676 | Date 05/07/2019 |
| Token No | SM/19-20/5949 06/07/2019 | Serial | 012 Last Visit: 06/07/2019 |
| Patient Name | Mrs. LAKHI BASU | Contact No | 9681065536 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI(M) | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||