Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10122 | Date 23/09/2021 |
| Token No | SM/21-22/5404 23/09/2021 | Serial | 049 Last Visit: 18/10/2021 |
| Patient Name | Mrs. RIJIYA BEGAM | Contact No | |
| Address | SHEORAPHULI | Age | 69 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||