Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03959 | Date 02/03/2019 |
| Token No | SM/18-19/9744 02/03/2019 | Serial | 063 Last Visit: 02/03/2019 |
| Patient Name | Miss KHUSNUDI PARVIN | Contact No | |
| Address | SEORAP[HULI CHATU GANG | Age | 12 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||