Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04038 | Date 06/03/2019 |
| Token No | SM/18-19/9971 06/03/2019 | Serial | 061 Last Visit: 06/03/2019 |
| Patient Name | Miss RUMPA MONDAL | Contact No | 6290496526 |
| Address | 10A/E G.T.ROAD GODAR BAGAN /LANE | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||