Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02964 | Date 11/01/2019 |
| Token No | SM/18-19/6742 14/01/2019 | Serial | 033 Last Visit: 14/01/2019 |
| Patient Name | Mrs. MALATI SARDAR | Contact No | |
| Address | VIVEKANANDA SARANI | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||