Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05420 | Date 13/06/2019 |
| Token No | SM/21-22/9403 28/01/2022 | Serial | 020 Last Visit: 18/05/2022 |
| Patient Name | Mrs. AVA CHAKRABORTY | Contact No | 9883078020 |
| Address | 6 PN CHAKRABORTY LANE CHATRA SERAMPORE | Age | 68 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||