Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01373 | Date 27/09/2018 |
| Token No | SM/18-19/2284 01/10/2018 | Serial | 004 Last Visit: 01/10/2018 |
| Patient Name | Mr. AMIT DUTTA | Contact No | 9432233417 |
| Address | 12, RABINDRA BHAWAN SARANI | Age | 39 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||