Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04187 | Date 12/03/2019 |
| Token No | SM/18-19/10486 13/03/2019 | Serial | 013 Last Visit: 13/03/2019 |
| Patient Name | Mr. TASIP ALAM | Contact No | 9874150886 |
| Address | 32 RISHRA CHAI ROAD | Age | 16 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||