Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02834 | Date 05/01/2019 |
| Token No | SM/18-19/10425 12/03/2019 | Serial | 016 Last Visit: 08/08/2019 |
| Patient Name | Mrs. KRISHNA PAUL | Contact No | 9836304972 |
| Address | 84 A POTUA PARA LANE | Age | 61 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||