Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03940 | Date 01/03/2019 |
| Token No | SM/18-19/9679 01/03/2019 | Serial | 054 Last Visit: 01/03/2019 |
| Patient Name | Miss DIPIKA MANNA | Contact No | 8697093069 |
| Address | CHATRA DAS PARA | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||