Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05179 | Date 21/05/2019 |
| Token No | SM/19-20/4690 17/06/2019 | Serial | 007 Last Visit: 05/08/2019 |
| Patient Name | Mrs. FAJILA BIBI | Contact No | 9163245484 |
| Address | 21 MUSALMAN PARA LANE SERAMPORE | Age | 56 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||