Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01715 | Date 27/10/2018 |
| Token No | SM/18-19/3056 29/10/2018 | Serial | 028 Last Visit: 30/10/2018 |
| Patient Name | Mr. SK SAHIL | Contact No | 9062750729 |
| Address | CHATRA MUSALMAN PARA | Age | 12 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||