Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08651 | Date 19/08/2020 |
| Token No | SM/19-20/25015 19/08/2020 | Serial | 027 Last Visit: 19/08/2020 |
| Patient Name | Mr. BIDUR DOLUI | Contact No | |
| Address | UPHC-IV | Age | 58 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||