Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00438 | Date 14/08/2018 |
| Token No | SM/18-19/487 14/08/2018 | Serial | 028 Last Visit: 14/08/2018 |
| Patient Name | Baby MAHEK KHATUN | Contact No | |
| Address | 41, MUSALMAN PARA, CHATRA | Age | 1.4 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||