Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00836 | Date 30/08/2018 |
| Token No | SM/18-19/6667 11/01/2019 | Serial | 024 Last Visit: 11/09/2021 |
| Patient Name | Mrs. RAMA MANDOL | Contact No | 8013332298 |
| Address | 154 CHATRA,BAGHER BAGAN | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||