Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02400 | Date 07/12/2018 |
| Token No | SM/19-20/16826 17/01/2020 | Serial | 047 Last Visit: 23/06/2025 |
| Patient Name | Mr. MOHAN LAL PAKIRA | Contact No | 7596915165 |
| Address | CHATRA DHARMOTALA | Age | 80 Years,5 Months,20 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||