Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06925 | Date 20/11/2019 |
| Token No | SM/19-20/13732 21/11/2019 | Serial | 070 Last Visit: 25/11/2019 |
| Patient Name | Mrs. PAPIA BHUIYA | Contact No | 9339062793 |
| Address | 4 KKM SARANI CHATRA SERAMPORE | Age | 34 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||