Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03913 | Date 28/02/2019 |
| Token No | SM/21-22/7927 20/12/2021 | Serial | 029 Last Visit: 20/12/2021 |
| Patient Name | Mrs. FATEMA BEGAM | Contact No | |
| Address | 26 K. D. LANE, | Age | 66 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||