Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10871 | Date 02/04/2022 |
| Token No | SM/22-23/11315 02/04/2022 | Serial | 009 Last Visit: 02/04/2022 |
| Patient Name | Mr. HFHF | Contact No | |
| Address | Age | 54 Y Male | |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||