Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08498 | Date 07/07/2020 |
| Token No | SM/19-20/23871 07/07/2020 | Serial | 036 Last Visit: 07/07/2020 |
| Patient Name | Mrs. JAYANTI BAIRAGI | Contact No | |
| Address | 11/B GANGULY BAGAN LANE | Age | 41 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||