Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03915 | Date 28/02/2019 |
| Token No | SM/18-19/9607 28/02/2019 | Serial | 029 Last Visit: 28/02/2019 |
| Patient Name | Mrs. SUMITA NANDY | Contact No | 8334982317 |
| Address | 7,CHATRA BARUIPARA LANE | Age | 14 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||