Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02817 | Date 04/01/2019 |
| Token No | SM/19-20/9916 06/09/2019 | Serial | 081 Last Visit: 19/12/2020 |
| Patient Name | Mrs. MIRA MONDAL | Contact No | 9674481194 |
| Address | 11, A P.N MUKHERJEE STREET | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||