Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01532 | Date 05/10/2018 |
| Token No | SM/18-19/4566 03/12/2018 | Serial | 032 Last Visit: 12/08/2021 |
| Patient Name | Mrs. HAZRA BIBI | Contact No | 7890681416 |
| Address | 21 CHATRA MUSALMAN PARA BYE LANE | Age | 39 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||