Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09253 | Date 01/03/2021 |
| Token No | SM/20-21/30201 01/03/2021 | Serial | 021 Last Visit: 01/03/2021 |
| Patient Name | Mr. MADHUSUDAN GHOSH | Contact No | |
| Address | CHATRA BOUBAZAR | Age | 40 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||