Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02501 | Date 13/12/2018 |
| Token No | SM/18-19/5173 13/12/2018 | Serial | 020 Last Visit: 13/12/2018 |
| Patient Name | Mr. IBRAHIM | Contact No | 9007755751 |
| Address | 4/A ARBINDO SARNI CHATRA | Age | 9 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||