Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03458 | Date 08/02/2019 |
| Token No | SM/18-19/8365 09/02/2019 | Serial | 010 Last Visit: 09/02/2019 |
| Patient Name | Mrs. BIJALI MAJHI | Contact No | |
| Address | CHARA BAGAN,BAURIYA PARA,BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||