Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04002 | Date 05/03/2019 |
| Token No | SM/18-19/9846 05/03/2019 | Serial | 047 Last Visit: 05/03/2019 |
| Patient Name | Miss PIYALI BHUIYA | Contact No | 8282829636 |
| Address | 2/3 SATCHASI PARA LANE BAIDYABATI(M) CHATRA | Age | 9.6 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||