Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03393 | Date 05/02/2019 |
| Token No | SM/18-19/8115 06/02/2019 | Serial | 009 Last Visit: 02/05/2019 |
| Patient Name | Mr. SK. SAFIK | Contact No | 9903863373 |
| Address | 21 KUMOR PARA, CHATRA | Age | 50 Y Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||