Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05819 | Date 18/07/2019 |
| Token No | SM/19-20/9943 07/09/2019 | Serial | 012 Last Visit: 07/11/2019 |
| Patient Name | Mrs. RESHMA BIBI | Contact No | 6289474100 |
| Address | 2/D CHILEKHANA ROAD, | Age | 26 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||