Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01005 | Date 08/09/2018 |
| Token No | SM/18-19/1412 08/09/2018 | Serial | 041 Last Visit: 24/08/2022 |
| Patient Name | Mrs. IRA DAS | Contact No | 9933624955 |
| Address | GOPALPUR | Age | 47.0 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||