Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05705 | Date 08/07/2019 |
| Token No | SM/19-20/6098 09/07/2019 | Serial | 003 Last Visit: 07/04/2021 |
| Patient Name | Miss MADHURI DAS | Contact No | 9088431122 |
| Address | A.P. GHOSH ROAD CHATRA | Age | 6 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||