Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04044 | Date 06/03/2019 |
| Token No | SM/18-19/9987 06/03/2019 | Serial | 077 Last Visit: 06/03/2019 |
| Patient Name | Miss TIASHA DAS | Contact No | 7685002419 |
| Address | CHATRA SITALATALA K.C. MUKHERJEE STREET | Age | 11 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||