Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03961 | Date 02/03/2019 |
| Token No | SM/18-19/9748 02/03/2019 | Serial | 067 Last Visit: 02/03/2019 |
| Patient Name | Miss NAMITA RUIDAS | Contact No | 8584042989 |
| Address | CHATRA SITALATALA | Age | 13 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||