Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03968 | Date 02/03/2019 |
| Token No | SM/18-19/9761 02/03/2019 | Serial | 080 Last Visit: 02/03/2019 |
| Patient Name | Miss PRIYA DAS | Contact No | 9051776321 |
| Address | 97/C CHATRA BAGER BAGAN | Age | 14 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||