Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10849 | Date 29/03/2022 |
| Token No | SM/21-22/11190 29/03/2022 | Serial | 049 Last Visit: 29/03/2022 |
| Patient Name | Mrs. SIMA BARIK | Contact No | |
| Address | 2 RAJDHARPUR GOV. COLONY | Age | 40 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||