Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06492 | Date 21/09/2019 |
| Token No | SM/19-20/10904 23/09/2019 | Serial | 031 Last Visit: 23/09/2019 |
| Patient Name | Mrs. SAWISTA KHATUN | Contact No | 7352279623 |
| Address | 4 MASTALIIPUR,BIHAR(CHATRA MUSALMAN PARA) | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||