Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02923 | Date 09/01/2019 |
| Token No | SM/18-19/6591 10/01/2019 | Serial | 018 Last Visit: 26/09/2019 |
| Patient Name | Mrs. ANJUM ARA | Contact No | 8820045799 |
| Address | 16 RANINDARA BHABAN ROAD | Age | 45 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||