Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04009 | Date 05/03/2019 |
| Token No | SM/18-19/9857 05/03/2019 | Serial | 058 Last Visit: 05/03/2019 |
| Patient Name | Miss BRISTI MONDAL | Contact No | 8017854602 |
| Address | CHATRA MANA PARA | Age | 8 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||