Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09887 | Date 28/07/2021 |
| Token No | SM/21-22/4833 07/09/2021 | Serial | 010 Last Visit: 07/09/2021 |
| Patient Name | Mr. DIPAK DAS | Contact No | 7890569925 |
| Address | PAHALAMPUR | Age | 26 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||