Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00704 | Date 25/08/2018 |
| Token No | SM/20-21/26342 05/10/2020 | Serial | 078 Last Visit: 07/10/2020 |
| Patient Name | Mrs. JAYASHREE KUNDU | Contact No | 9830553562 |
| Address | 76,A.P.GHOSH ROAD | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||