Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09756 | Date 25/06/2021 |
| Token No | SM/21-22/2581 25/06/2021 | Serial | 048 Last Visit: 25/06/2021 |
| Patient Name | Mr. SAJAL DAS | Contact No | |
| Address | PROVASNAGAR | Age | 51 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||