Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01515 | Date 04/10/2018 |
| Token No | SM/18-19/2468 04/10/2018 | Serial | 066 Last Visit: 04/10/2018 |
| Patient Name | Baby RESHMI KHATUN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 1 YRS 9 MNTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||