Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03045 | Date 17/01/2019 |
| Token No | SM/19-20/18598 24/02/2020 | Serial | 074 Last Visit: 27/02/2020 |
| Patient Name | Mrs. RINA BIBI | Contact No | 8478988101 |
| Address | 89C MALLICK PARA | Age | 75 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||