Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10764 | Date 08/03/2022 |
| Token No | SM/21-22/10808 15/03/2022 | Serial | 028 Last Visit: 15/03/2022 |
| Patient Name | Mrs. SAMPA SARKAR | Contact No | |
| Address | SERAMPORE | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||