Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03202 | Date 29/01/2019 |
| Token No | SM/18-19/7581 30/01/2019 | Serial | 011 Last Visit: 30/01/2019 |
| Patient Name | Mr. BIKASH DAS | Contact No | 9674559563 |
| Address | 14, SIDESWARI LANE | Age | 63 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||