Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 08849 | Date 12/10/2020 |
| Token No | SM/21-22/5816 05/10/2021 | Serial | 067 Last Visit: 05/10/2021 |
| Patient Name | Mrs. KAJAL SHAW | Contact No | 7449959627 |
| Address | 247/A CHARABAGAN BARUIPARA, BAIDYABATI(M) | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||