Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07175 | Date 17/12/2019 |
| Token No | SM/19-20/15485 17/12/2019 | Serial | 036 Last Visit: 17/12/2019 |
| Patient Name | Mrs. GEETA RANI KOTAL | Contact No | |
| Address | GOSWAMI STREET | Age | 73 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||