Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01179 | Date 18/09/2018 |
| Token No | SM/18-19/8545 13/02/2019 | Serial | 012 Last Visit: 17/07/2021 |
| Patient Name | Miss NASIMA BANU | Contact No | 8017676928 |
| Address | SHEORAPHULY | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||