Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10574 | Date 18/01/2022 |
| Token No | SM/21-22/9130 19/01/2022 | Serial | 036 Last Visit: 19/01/2022 |
| Patient Name | Mrs. ROZY BIBI | Contact No | 9332635984 |
| Address | 29 NO B CHATRA MUSALMAN PARA BYE LANE SERAMPORE M | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||