Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03437 | Date 07/02/2019 |
| Token No | SM/19-20/2902 17/05/2019 | Serial | 006 Last Visit: 17/05/2019 |
| Patient Name | Mrs. SUBHRA DAS | Contact No | 9143081815 |
| Address | 3 SHIDHYSWARI LANE | Age | 58 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||