Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01101 | Date 13/09/2018 |
| Token No | SM/18-19/1603 13/09/2018 | Serial | 026 Last Visit: 13/09/2018 |
| Patient Name | Baby RIYA SARKAR | Contact No | 8609869276 |
| Address | 32, PACHU BABU BAJAR BARAL BAGAN LANE | Age | 5.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||