Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00561 | Date 18/08/2018 |
| Token No | SM/18-19/655 18/08/2018 | Serial | 051 Last Visit: 18/08/2018 |
| Patient Name | Baby TANUJA KHATUN | Contact No | 9748252282 |
| Address | CHATRA MUSALMAN PARA | Age | 8 Months Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||