Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09955 | Date 17/08/2021 |
| Token No | SM/21-22/4189 18/08/2021 | Serial | 039 Last Visit: 18/08/2021 |
| Patient Name | Mr. SUPRIYA DAS | Contact No | 7878071280 |
| Address | 95,N.S AVENUE SERAMPORE | Age | 55 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||