Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02308 | Date 03/12/2018 |
| Token No | SM/18-19/4619 04/12/2018 | Serial | 005 Last Visit: 04/12/2018 |
| Patient Name | Mrs. HALIMA BIBI | Contact No | 8444979212 |
| Address | CHATRA ARABINDA SWARANI | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||