Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06752 | Date 24/10/2019 |
| Token No | SM/19-20/12339 24/10/2019 | Serial | 014 Last Visit: 24/10/2019 |
| Patient Name | Mr. MONGOL DAS | Contact No | 9051218237 |
| Address | 242 G.T.ROAD CHATRA BAHER BAGAN | Age | 38 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||