Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09970 | Date 23/08/2021 |
| Token No | SM/21-22/5250 20/09/2021 | Serial | 020 Last Visit: 20/09/2021 |
| Patient Name | Mrs. SANDYA DAS | Contact No | 9903044907 |
| Address | 31,DHARMATALA LANE CHATRA SERAMPORE | Age | 49 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||