Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06626 | Date 14/10/2019 |
| Token No | SM/21-22/9450 29/01/2022 | Serial | 018 Last Visit: 16/08/2022 |
| Patient Name | Mrs. SHIBANI DAS | Contact No | 9007115689 |
| Address | 21 P N K BENERJEE LANE, SERAMPORE | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||