Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06412 | Date 14/09/2019 |
| Token No | SM/19-20/10383 14/09/2019 | Serial | 062 Last Visit: 14/09/2019 |
| Patient Name | Mrs. ARITA BEGAM | Contact No | |
| Address | TARAPUKUR PROVASNAGAR | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||