Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02869 | Date 07/01/2019 |
| Token No | SM/18-19/6402 07/01/2019 | Serial | 056 Last Visit: 07/01/2019 |
| Patient Name | Miss JULEKHA KHATUN | Contact No | 9088399717 |
| Address | 23 1/A CHATRA KUMAR PARA | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 22 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||