Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02728 | Date 29/12/2018 |
| Token No | SM/18-19/5951 29/12/2018 | Serial | 006 Last Visit: 06/05/2023 |
| Patient Name | Mr. MOHAN LAL PAL | Contact No | 9831887680 |
| Address | CHATRA TETUL TALA BAZAR | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||