Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02137 | Date 26/11/2018 |
| Token No | SM/19-20/12178 22/10/2019 | Serial | 001 Last Visit: 23/10/2019 |
| Patient Name | Mrs. HAJERA BIBI | Contact No | 8585878581 |
| Address | 4CHILEKHARA ROAD,MALLIK PARA | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||