Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09639 | Date 24/05/2021 |
| Token No | SM/21-22/1753 28/05/2021 | Serial | 022 Last Visit: 28/05/2021 |
| Patient Name | Mrs. BAISHALI DAS | Contact No | 8910457426 |
| Address | 9 HOSPITAL LANE SERAMPORE | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||