Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08119 | Date 20/04/2020 |
| Token No | SM/19-20/21370 20/04/2020 | Serial | 045 Last Visit: 20/04/2020 |
| Patient Name | Mrs. SOMA BEGAM | Contact No | 7980264858 |
| Address | 43 CHATRA MUSALMAN PARA | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||