Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03953 | Date 02/03/2019 |
| Token No | SM/18-19/9719 02/03/2019 | Serial | 038 Last Visit: 02/03/2019 |
| Patient Name | Miss SHRESTHA MANNA | Contact No | 9903252167 |
| Address | 114/1 RAMKRISHANA ROAD | Age | 12 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||