Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03013 | Date 15/01/2019 |
| Token No | SM/19-20/9927 06/09/2019 | Serial | 092 Last Visit: 13/07/2020 |
| Patient Name | Mrs. SHIBANI MALLICK | Contact No | 8584933013 |
| Address | BELU NETAJI NAGAR | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||