Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08594 | Date 28/07/2020 |
| Token No | SM/19-20/24542 28/07/2020 | Serial | 025 Last Visit: 28/07/2020 |
| Patient Name | Mr. KALIPADA SAMANTA | Contact No | |
| Address | UPHC-I | Age | 72 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||