Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10696 | Date 21/02/2022 |
| Token No | SM/21-22/10242 24/02/2022 | Serial | 045 Last Visit: 01/08/2022 |
| Patient Name | Mrs. JUI DOLUI | Contact No | 9836352035 |
| Address | 8 BAHIR SERAMPORE | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||