Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09711 | Date 11/06/2021 |
| Token No | SM/21-22/2177 11/06/2021 | Serial | 043 Last Visit: 11/06/2021 |
| Patient Name | Mrs. KANJILA BEGAM | Contact No | |
| Address | 31AMIAJAN DARJI LANE MALLICKPARA | Age | 38 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||