Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04275 | Date 18/03/2019 |
| Token No | SM/19-20/11065 25/09/2019 | Serial | 007 Last Visit: 01/06/2020 |
| Patient Name | Mrs. MUMENA BIBI | Contact No | 9088594650 |
| Address | 33 CHATRA MUSALMAN PARA SERAMPORE (M) | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||