Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04812 | Date 22/04/2019 |
| Token No | SM/21-22/2528 24/06/2021 | Serial | 029 Last Visit: 06/07/2021 |
| Patient Name | Mrs. MITHU DAS | Contact No | 9230479008 |
| Address | 58/7 SATCHASI PARA CHATRA SERAMPORE | Age | 37 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||