Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 08378 | Date 18/06/2020 |
| Token No | SM/19-20/23208 18/06/2020 | Serial | 007 Last Visit: 18/06/2020 |
| Patient Name | Mrs. MILAN DEY | Contact No | 9903278381 |
| Address | 6/35/1/A B.P. 1ST LANE | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||