Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01948 | Date 14/11/2018 |
| Token No | SM/18-19/3623 14/11/2018 | Serial | 012 Last Visit: 14/11/2018 |
| Patient Name | Baby ANURAG JANA | Contact No | 8974782635 |
| Address | CHATRA BAGHER BAGAN | Age | 1 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||