Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08722 | Date 08/09/2020 |
| Token No | SM/20-21/25650 12/09/2020 | Serial | 012 Last Visit: 12/09/2020 |
| Patient Name | Mrs. ASHIMA BAG | Contact No | 9051306041 |
| Address | 24/A CHATRA LANKAR BAGAN, BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||