Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04911 | Date 25/04/2019 |
| Token No | SM/19-20/1790 27/04/2019 | Serial | 039 Last Visit: 30/04/2019 |
| Patient Name | Mr. NOOR ALAM | Contact No | 9874150886 |
| Address | RISHRA CHI ROAD | Age | 19 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||