Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10576 | Date 18/01/2022 |
| Token No | SM/21-22/9335 25/01/2022 | Serial | 040 Last Visit: 25/01/2022 |
| Patient Name | Mrs. SAWISTA KHATUN | Contact No | |
| Address | SHEORAPHULI | Age | 32 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||