Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01025 | Date 10/09/2018 |
| Token No | SM/18-19/2020 25/09/2018 | Serial | 002 Last Visit: 09/10/2018 |
| Patient Name | Mrs. SUDHA MAJHI | Contact No | |
| Address | GODAR BAGAN CHATRA | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||