Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08968 | Date 11/11/2020 |
| Token No | SM/20-21/27492 11/11/2020 | Serial | 049 Last Visit: 11/11/2020 |
| Patient Name | Mrs. KAJAL SASMAL | Contact No | |
| Address | SHEORAPHULI | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||