Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01500 | Date 04/10/2018 |
| Token No | SM/19-20/24014 11/07/2020 | Serial | 005 Last Visit: 07/08/2020 |
| Patient Name | Mrs. JYOTI SHAW | Contact No | 7980016787 |
| Address | RISHRA CHAMPA ROAD | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||