Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10093 | Date 16/09/2021 |
| Token No | SM/21-22/5161 16/09/2021 | Serial | 033 Last Visit: 16/09/2021 |
| Patient Name | Mrs. GITA MALIK | Contact No | |
| Address | CHATRA DHAMATALA | Age | 60 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||