Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08387 | Date 18/06/2020 |
| Token No | SM/19-20/23323 22/06/2020 | Serial | 040 Last Visit: 22/06/2020 |
| Patient Name | Mrs. NAJIMA KHATUN | Contact No | 8481988133 |
| Address | 5/A/2 CHATRA MUSALMAN PARA BYE LANE SERAMPORE | Age | 21 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||