Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02006 | Date 16/11/2018 |
| Token No | SM/18-19/9345 23/02/2019 | Serial | 031 Last Visit: 12/09/2019 |
| Patient Name | Mrs. BANI DAS | Contact No | 7890413831 |
| Address | 37A CHATRA DHARMOTALA LANE | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||