Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00743 | Date 27/08/2018 |
| Token No | SM/18-19/6572 09/01/2019 | Serial | 061 Last Visit: 09/01/2019 |
| Patient Name | Baby JAINUL ABEDIN | Contact No | 9007993724 |
| Address | 5, ARBINDA SARANI CHATRA | Age | 1.3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||