Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06262 | Date 29/08/2019 |
| Token No | SM/19-20/9438 30/08/2019 | Serial | 010 Last Visit: 30/08/2019 |
| Patient Name | Mrs. SARITA DUBEY | Contact No | 8795935209 |
| Address | 186/A G. T. ROAD,SUKANTA PARK | Age | 27 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||