Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09682 | Date 07/06/2021 |
| Token No | SM/21-22/8924 13/01/2022 | Serial | 057 Last Visit: 02/05/2022 |
| Patient Name | Mrs. NIBEDITA BANERJEE | Contact No | 9883354317 |
| Address | 248/1 J.T ROAD BAIDHYABATI | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||