Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03081 | Date 19/01/2019 |
| Token No | SM/18-19/7177 21/01/2019 | Serial | 045 Last Visit: 21/01/2019 |
| Patient Name | Mr. ARUN DEY | Contact No | |
| Address | Age | 61 YRS Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||