Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04032 | Date 06/03/2019 |
| Token No | SM/18-19/9965 06/03/2019 | Serial | 055 Last Visit: 06/03/2019 |
| Patient Name | Miss TUHINA DAS | Contact No | 8013682254 |
| Address | 431G CHATRA MUKHERJEE PARA | Age | 16 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||