Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02258 | Date 01/12/2018 |
| Token No | SM/18-19/4642 04/12/2018 | Serial | 028 Last Visit: 04/12/2018 |
| Patient Name | Mrs. SIKHA NATH | Contact No | 9804765711 |
| Address | 10/B CHATRA KUMAR PARA | Age | 42 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||