Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01726 | Date 27/10/2018 |
| Token No | SM/18-19/3046 29/10/2018 | Serial | 018 Last Visit: 05/11/2018 |
| Patient Name | Mr. SK RABBUL | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||