Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01205 | Date 19/09/2018 |
| Token No | SM/18-19/1792 19/09/2018 | Serial | 004 Last Visit: 22/09/2018 |
| Patient Name | Mr. BISWANATH MALAKAR | Contact No | 9088374485 |
| Address | 34/B/27 SUKANTA PALLI PRABHAS NAGAR | Age | 62 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||