Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06871 | Date 15/11/2019 |
| Token No | SM/19-20/13304 15/11/2019 | Serial | 037 Last Visit: 15/11/2019 |
| Patient Name | Mr. SANJAY DEY | Contact No | |
| Address | PROVASNAGAR | Age | 46 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||