Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05884 | Date 22/07/2019 |
| Token No | SM/21-22/9227 21/01/2022 | Serial | 035 Last Visit: 21/01/2022 |
| Patient Name | Mr. AMAR DAS | Contact No | 9163078529 |
| Address | 135A A.P GHOSH ROAD CHATRA SERAMPORE | Age | 65 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||