Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 09323 | Date 15/03/2021 |
| Token No | SM/20-21/30831 17/03/2021 | Serial | 010 Last Visit: 21/05/2021 |
| Patient Name | Mrs. SHAIRUN NESHA | Contact No | 7044241582 |
| Address | 13 K. M. BHATTACHARJEE STREET | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||