Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10707 | Date 22/02/2022 |
| Token No | SM/21-22/10192 23/02/2022 | Serial | 043 Last Visit: 23/02/2022 |
| Patient Name | Mrs. MADHUMITA DUTTA | Contact No | 9830867909 |
| Address | 67/H/2 G.T. ROAD WEST | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||