Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02758 | Date 31/12/2018 |
| Token No | SM/18-19/6037 31/12/2018 | Serial | 036 Last Visit: 31/12/2018 |
| Patient Name | Mrs. MONOWARA BEGAM | Contact No | 9830681972 |
| Address | 1,CHILEKHANA ROAD MALLICKPARA | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||