Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02995 | Date 14/01/2019 |
| Token No | SM/18-19/6780 14/01/2019 | Serial | 071 Last Visit: 14/01/2019 |
| Patient Name | Baby MUSKAN KHATUN | Contact No | 8444979212 |
| Address | 1 MUSALMAN PARA LANE, CHATRA | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||