Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08200 | Date 02/05/2020 |
| Token No | SM/19-20/22002 06/05/2020 | Serial | 027 Last Visit: 06/05/2020 |
| Patient Name | Mrs. NASRIN SULTAN | Contact No | 8910372746 |
| Address | 20, KANAI DEWAN TALA LANE SHEORAPHULY SERAMPORE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||