Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01345 | Date 26/09/2018 |
| Token No | SM/19-20/12179 22/10/2019 | Serial | 002 Last Visit: 22/10/2019 |
| Patient Name | Mrs. RINA BIBI | Contact No | 8481036957 |
| Address | 4 CHINE KHANA ROAD | Age | 50 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||