Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10100 | Date 18/09/2021 |
| Token No | SM/21-22/5244 20/09/2021 | Serial | 014 Last Visit: 22/10/2021 |
| Patient Name | Mrs. SAFINA KHAN | Contact No | 8910236415 |
| Address | 19 T.C. GOSWAMI STREET SERAMPORE | Age | 28 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||