Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01368 | Date 27/09/2018 |
| Token No | SM/21-22/8212 28/12/2021 | Serial | 035 Last Visit: 28/12/2021 |
| Patient Name | Mrs. SHANTI PAGRE | Contact No | 8777657269 |
| Address | MALA BER (RISHRA) | Age | 54YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||