Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00806 | Date 29/08/2018 |
| Token No | SM/18-19/1047 30/08/2018 | Serial | 001 Last Visit: 01/11/2018 |
| Patient Name | Mrs. REBOTI DUTTA | Contact No | 9681676994 |
| Address | 52A CHATRA BARUIPARA LANE | Age | 74.0 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | 140/89 mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||