Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02688 | Date 27/12/2018 |
| Token No | SM/18-19/5770 27/12/2018 | Serial | 028 Last Visit: 27/12/2018 |
| Patient Name | Mrs. CHHAYA DUTTA | Contact No | 9051233628 |
| Address | PROVASNAGAR | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||