Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 09574 | Date 03/05/2021 |
| Token No | SM/21-22/9942 16/02/2022 | Serial | 028 Last Visit: 08/03/2022 |
| Patient Name | Mrs. KUMKUM PAL | Contact No | 8013482815 |
| Address | 14/DOCTOR BAGAN SERAMPORE | Age | 62 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||