Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08468 | Date 02/07/2020 |
| Token No | SM/19-20/23687 03/07/2020 | Serial | 010 Last Visit: 05/11/2020 |
| Patient Name | Mrs. JARINA BIBI | Contact No | 7890084199 |
| Address | 5 CHATRA ARBINDA SARANI SERAMPORE | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||