Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08996 | Date 26/11/2020 |
| Token No | SM/21-22/7199 26/11/2021 | Serial | 020 Last Visit: 26/11/2021 |
| Patient Name | Mr. JAYANTA SIL | Contact No | |
| Address | PROVASNAGAR | Age | 49 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||