Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03388 | Date 05/02/2019 |
| Token No | SM/18-19/8073 05/02/2019 | Serial | 064 Last Visit: 05/02/2019 |
| Patient Name | Baby SARIFA KHATUN | Contact No | 9339444555 |
| Address | 47 CHATRA,M P ROAD,SERAMPORE, | Age | 2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||