Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04312 | Date 20/03/2019 |
| Token No | SM/19-20/6684 17/07/2019 | Serial | 056 Last Visit: 11/09/2019 |
| Patient Name | Mr. SAMBHU DUTTA | Contact No | 8420848825 |
| Address | 17B CHATRA CHAPA TALA SERAMPORE | Age | 28 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||