Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08673 | Date 26/08/2020 |
| Token No | SM/21-22/5867 07/10/2021 | Serial | 050 Last Visit: 23/10/2021 |
| Patient Name | Mrs. GULSARINA KHATUN | Contact No | 9874770573 |
| Address | 21 MUSALMAN PARA ROAD SERAMPORE | Age | 23 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||