Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11571 | Date 14/09/2022 |
| Token No | SM/22-23/16717 14/09/2022 | Serial | 022 Last Visit: 14/09/2022 |
| Patient Name | Master NILAV RAM | Contact No | |
| Address | 19,DR.G.C.GOSWAMI STREET | Age | 6 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||