Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10586 | Date 19/01/2022 |
| Token No | SM/21-22/9183 20/01/2022 | Serial | 042 Last Visit: 22/02/2022 |
| Patient Name | Mr. BISWANATH DAS | Contact No | |
| Address | 22 P.N.K.B.LANE,CHATRA | Age | 70 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||