Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06118 | Date 16/08/2019 |
| Token No | SM/21-22/2029 08/06/2021 | Serial | 031 Last Visit: 14/06/2021 |
| Patient Name | Mr. BIKRAM KUMAR SINGH | Contact No | 9804212975 |
| Address | 42/A BARA BAGAN LANE SERAMPORE , MALLICKPARA , HOOGHLY | Age | 48 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||