Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 00701 | Date 25/08/2018 |
| Token No | SM/18-19/6109 02/01/2019 | Serial | 018 Last Visit: 31/01/2019 |
| Patient Name | Mrs. NILA SHAW | Contact No | 9830637480 |
| Address | N.N.ROY STREET | Age | 44.0 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||