Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03642 | Date 18/02/2019 |
| Token No | SM/18-19/8984 19/02/2019 | Serial | 014 Last Visit: 26/02/2019 |
| Patient Name | Mrs. SEFALI DAS | Contact No | 7890661525 |
| Address | SHEWRAPHULI BAULI PARA | Age | 48 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||