Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01459 | Date 01/10/2018 |
| Token No | SM/18-19/2457 04/10/2018 | Serial | 055 Last Visit: 04/10/2018 |
| Patient Name | Baby RESHMA KATHUN | Contact No | |
| Address | 12 CHATRA MUSALMAN PRA | Age | 1 YRS 6 MNTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||