Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03951 | Date 02/03/2019 |
| Token No | SM/18-19/9713 02/03/2019 | Serial | 032 Last Visit: 02/03/2019 |
| Patient Name | Miss BARSHA ASH | Contact No | 9903526745 |
| Address | CHATRA DAS PARA HARIJON ROAD | Age | 10 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||