Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02615 | Date 20/12/2018 |
| Token No | SM/18-19/5558 21/12/2018 | Serial | 008 Last Visit: 04/03/2021 |
| Patient Name | Mrs. DIPTI SANTARA | Contact No | 9038511905 |
| Address | 140/A N S EVENEU | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||