Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02013 | Date 16/11/2018 |
| Token No | SM/18-19/3846 19/11/2018 | Serial | 013 Last Visit: 30/04/2019 |
| Patient Name | Mrs. DEVI PAL | Contact No | 8335940344 |
| Address | 23A CHATRA KUMAR PARA | Age | 65 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||