Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04348 | Date 23/03/2019 |
| Token No | SM/18-19/11054 23/03/2019 | Serial | 058 Last Visit: 28/03/2019 |
| Patient Name | Baby RUPSA KHATUN | Contact No | 7449738066 |
| Address | CHATRA MUSALMAN PARA SERAMPORE | Age | 1.4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 7.96 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||