Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10717 | Date 23/02/2022 |
| Token No | SM/21-22/10187 23/02/2022 | Serial | 038 Last Visit: 23/02/2022 |
| Patient Name | Miss SAYANTI GUIN | Contact No | |
| Address | 90,A CHATRA BARUI PARA | Age | 20 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||