Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02833 | Date 05/01/2019 |
| Token No | SM/18-19/7424 25/01/2019 | Serial | 014 Last Visit: 08/08/2019 |
| Patient Name | Mr. BIKASH PAUL | Contact No | 9836304972 |
| Address | 84 A POTUA PARA LANE | Age | 66 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||