Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03713 | Date 20/02/2019 |
| Token No | SM/20-21/27463 11/11/2020 | Serial | 020 Last Visit: 22/06/2021 |
| Patient Name | Mrs. SWAPNA CHAKRABOTY | Contact No | 9830200603 |
| Address | 30/1 NABIN CHAKRABORTY LANE, 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 | |||