Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03188 | Date 25/01/2019 |
| Token No | SM/19-20/3579 28/05/2019 | Serial | 020 Last Visit: 29/04/2021 |
| Patient Name | Mrs. SANDHYA PAUL | Contact No | 8583822278 |
| Address | 38, CHATRA, KUMER PARA | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||