Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09291 | Date 06/03/2021 |
| Token No | SM/20-21/30550 09/03/2021 | Serial | 025 Last Visit: 17/04/2021 |
| Patient Name | Mr. KUNDAN ROY | Contact No | 9830736912 |
| Address | 23A BENIA PARA LANE SERAMPORE | Age | 22 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||