Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06319 | Date 03/09/2019 |
| Token No | SM/19-20/9772 04/09/2019 | Serial | 003 Last Visit: 23/11/2019 |
| Patient Name | Mr. SWAPAN SARDAR | Contact No | 9748508092 |
| Address | 143/A BHATTCHARJEE GARDENBYE LANE , NABAGARAM , BAIDYABATI(M) | Age | 43 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||