Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08866 | Date 15/10/2020 |
| Token No | SM/20-21/26754 16/10/2020 | Serial | 031 Last Visit: 16/10/2020 |
| Patient Name | Mrs. RANI BEGAM | Contact No | 8582031975 |
| Address | 15 CHATRA MUSALMAN PARA SERAMPORE | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||