Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09425 | Date 05/04/2021 |
| Token No | SM/21-22/5088 14/09/2021 | Serial | 024 Last Visit: 28/09/2021 |
| Patient Name | Miss NAZIA KHATOON | Contact No | 7450961997 |
| Address | 10,T.C GOSWAMI STREET, SERAMPORE | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||