Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04202 | Date 15/03/2019 |
| Token No | SM/18-19/10514 15/03/2019 | Serial | 007 Last Visit: 15/03/2019 |
| Patient Name | Mrs. ARCHANA DAS | Contact No | 7718719096 |
| Address | PROVAS NAGAR CHATRA | Age | 44 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||