Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02875 | Date 07/01/2019 |
| Token No | SM/18-19/6417 07/01/2019 | Serial | 071 Last Visit: 07/01/2019 |
| Patient Name | Baby SK SAKIL | Contact No | 9830953893 |
| Address | 23/A MEYAJAN DARJI LANE | Age | 2 Y 3 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||