Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10138 | Date 25/09/2021 |
| Token No | SM/21-22/5502 25/09/2021 | Serial | 041 Last Visit: 25/09/2021 |
| Patient Name | Mr. BHOLANATH CHAKRABORTY | Contact No | |
| Address | 76 N.C.CHAKRABORTY LANE | Age | 74 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||