Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09961 | Date 19/08/2021 |
| Token No | SM/21-22/4360 24/08/2021 | Serial | 049 Last Visit: 23/09/2021 |
| Patient Name | Mrs. SWARNALI GHORUI | Contact No | 7980319232 |
| Address | 34/1 KUMIRJOLA ROAD | Age | 24 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||