Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03818 | Date 23/02/2019 |
| Token No | SM/19-20/14101 27/11/2019 | Serial | 010 Last Visit: 29/11/2019 |
| Patient Name | Mrs. MADHUMITA RAM | Contact No | 7450862634 |
| Address | 22/18/1CHATRA TETULTALA , BAIDYABATI(M) | Age | 31 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||