Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03398 | Date 06/02/2019 |
| Token No | SM/18-19/8120 06/02/2019 | Serial | 014 Last Visit: 06/02/2019 |
| Patient Name | Mrs. SIKHA DAS | Contact No | 9903656344 |
| Address | 17/1 KALITALA LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||