Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02720 | Date 28/12/2018 |
| Token No | SM/18-19/6005 31/12/2018 | Serial | 004 Last Visit: 06/03/2020 |
| Patient Name | Mrs. DURGA RAY | Contact No | |
| Address | 18 RAY GHAT LANE | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||