Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09474 | Date 17/04/2021 |
| Token No | SM/21-22/589 19/04/2021 | Serial | 056 Last Visit: 27/04/2021 |
| Patient Name | Mr. SAMIR GHOSH | Contact No | 7003965188 |
| Address | 52/53/B BARA BAGAN LANE SERAMPORE | Age | 57 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||