Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02207 | Date 29/11/2018 |
| Token No | SM/18-19/10813 19/03/2019 | Serial | 006 Last Visit: 20/12/2019 |
| Patient Name | Mr. NILMUNI DAS | Contact No | 9830646351 |
| Address | A.P GHOSH ROAD CHATRA | Age | 70 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||