Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04183 | Date 12/03/2019 |
| Token No | SM/22-23/15890 20/08/2022 | Serial | 023 Last Visit: 20/08/2022 |
| Patient Name | Mrs. SABNAM BEGAM | Contact No | 8017676928 |
| Address | SHEORAPHULI,COLD DIPO | Age | 30 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||