Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01701 | Date 27/10/2018 |
| Token No | SM/18-19/3067 29/10/2018 | Serial | 039 Last Visit: 22/10/2019 |
| Patient Name | Mrs. TUMPA BHALLA | Contact No | 8981495654 |
| Address | CHATRA TETUL TALA | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||