Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08964 | Date 11/11/2020 |
| Token No | SM/20-21/27534 12/11/2020 | Serial | 040 Last Visit: 13/11/2020 |
| Patient Name | Mr. PRABHAT DAS | Contact No | 8583924411 |
| Address | 117/1/A G T ROAD CHATRA, BAIDYABATI(M) | Age | 64 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||