Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07139 | Date 13/12/2019 |
| Token No | SM/21-22/6713 09/11/2021 | Serial | 039 Last Visit: 09/11/2021 |
| Patient Name | Miss AMRITA ADAK | Contact No | 9088360322 |
| Address | 15/15 AMULKANAN HOUSING | Age | 15 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||