Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00714 | Date 27/08/2018 |
| Token No | SM/18-19/883 27/08/2018 | Serial | 016 Last Visit: 27/08/2018 |
| Patient Name | Baby SK REHAN ALI | Contact No | 7890084199 |
| Address | 5CHATRA ARABINDA SARANI | Age | 3.5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||