Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01422 | Date 29/09/2018 |
| Token No | SM/18-19/2248 29/09/2018 | Serial | 036 Last Visit: 29/09/2018 |
| Patient Name | Mrs. PAPRI BISWAS | Contact No | 9830131874 |
| Address | 416/1 G T ROAD CHATRA BAUBAZAR | Age | 47 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||