Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 09122 | Date 05/01/2021 |
| Token No | SM/20-21/29213 08/01/2021 | Serial | 051 Last Visit: 24/05/2021 |
| Patient Name | Mrs. PURNIMA HARI | Contact No | 9330703068 |
| Address | 54A/1/K, K M BHATTCHARJEE STREET SERAMPORE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||