Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 09219 | Date 27/01/2021 |
| Token No | SM/20-21/29821 27/01/2021 | Serial | 045 Last Visit: 27/01/2021 |
| Patient Name | Mr. RAM DULAR RAM | Contact No | |
| Address | 7 DEY GHAT LANE SERAMPORE | Age | 71 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||