Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04025 | Date 06/03/2019 |
| Token No | SM/18-19/9946 06/03/2019 | Serial | 036 Last Visit: 06/03/2019 |
| Patient Name | Miss MOUSALI NATH | Contact No | 9836594725 |
| Address | CHATRA LANKAR BAGAN SACHASI PARA | Age | 7 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||