Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03692 | Date 19/02/2019 |
| Token No | SM/18-19/8998 19/02/2019 | Serial | 028 Last Visit: 11/07/2019 |
| Patient Name | Mr. MOHON LAL RAM | Contact No | 8274900535 |
| Address | CHATRA TETUL TALA,BAIDYABATI(M) | Age | 82 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||