Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01516 | Date 04/10/2018 |
| Token No | SM/18-19/2473 04/10/2018 | Serial | 071 Last Visit: 22/05/2019 |
| Patient Name | Baby ROUNAK PRAVEEN | Contact No | |
| Address | CHATRA MUSALAMAN PARA | Age | 10 MNTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||