Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09868 | Date 23/07/2021 |
| Token No | SM/21-22/3438 23/07/2021 | Serial | 054 Last Visit: 23/07/2021 |
| Patient Name | Mrs. ANJALI ROY | Contact No | |
| Address | TALPUKUR BATTALA | Age | 55 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||