Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09064 | Date 17/12/2020 |
| Token No | SM/20-21/28530 17/12/2020 | Serial | 036 Last Visit: 17/12/2020 |
| Patient Name | Baby PRIYANKA DAS | Contact No | |
| Address | SERAMPORE | Age | 10 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||