Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08979 | Date 18/11/2020 |
| Token No | SM/20-21/27602 18/11/2020 | Serial | 024 Last Visit: 18/11/2020 |
| Patient Name | Mr. GOLAM RAHMAN | Contact No | |
| Address | SHEORAPHULI | Age | 48 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||