Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01482 | Date 03/10/2018 |
| Token No | SM/18-19/2391 03/10/2018 | Serial | 046 Last Visit: 24/04/2019 |
| Patient Name | Baby SAFIYA KHATUN | Contact No | 8444979212 |
| Address | CHTARA ARBINDA SARANI | Age | 1 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||