Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 09726 | Date 15/06/2021 |
| Token No | SM/21-22/2303 16/06/2021 | Serial | 003 Last Visit: 16/06/2021 |
| Patient Name | Mrs. NAHID MOHAMMAD NIZAMUDDIN | Contact No | 9748511377 |
| Address | 56 NAGENDRA NATH ROY STREET SERAMPORE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||