Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03449 | Date 07/02/2019 |
| Token No | SM/18-19/8528 12/02/2019 | Serial | 132 Last Visit: 10/06/2019 |
| Patient Name | Mr. MADAN MOHAN PARUI | Contact No | 9062335537 |
| Address | CHATRA LANKER BAGAN,BAIDYABATI(M) | Age | 75 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||