Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02018 | Date 19/11/2018 |
| Token No | SM/19-20/3164 22/05/2019 | Serial | 005 Last Visit: 23/11/2020 |
| Patient Name | Mr. SK SIRAJ | Contact No | 9231506296 |
| Address | 1, MUSALMAN PARA BY LANE | Age | 67 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||