Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10101 | Date 18/09/2021 |
| Token No | SM/21-22/5261 20/09/2021 | Serial | 031 Last Visit: 09/03/2022 |
| Patient Name | Mrs. REHANA KHATOON | Contact No | 8274041533 |
| Address | 9 PARSI LANE SERAMPORE | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||