Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01271 | Date 22/09/2018 |
| Token No | SM/18-19/1933 22/09/2018 | Serial | 046 Last Visit: 22/09/2018 |
| Patient Name | Baby MISTI PRAMANIK | Contact No | 6290744267 |
| Address | CHATRA BAGHER BAGAN | Age | 2.4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||