Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00677 | Date 24/08/2018 |
| Token No | SM/18-19/849 25/08/2018 | Serial | 018 Last Visit: 02/11/2018 |
| Patient Name | Mr. NILMONI HALDAR | Contact No | |
| Address | 134 BARUI PARA SHIB TALA | Age | 70 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||