Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05603 | Date 27/06/2019 |
| Token No | SM/19-20/6045 08/07/2019 | Serial | 018 Last Visit: 08/07/2019 |
| Patient Name | Mr. SUJIT KANTI GHOSH | Contact No | 9875458983 |
| Address | TALPUKUR SERAMPORE-3 DAKSHIN RAJYADHARPUR | Age | 47 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 88 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||