Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10828 | Date 23/03/2022 |
| Token No | SM/21-22/11078 25/03/2022 | Serial | 014 Last Visit: 25/03/2022 |
| Patient Name | Mrs. PAMPA DAS BHOUMICK | Contact No | 9007541546 |
| Address | 54 BARA BAGAN LANE SERAMPORE MALLICKPARA | Age | 36 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||