Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03905 | Date 28/02/2019 |
| Token No | SM/18-19/9585 28/02/2019 | Serial | 007 Last Visit: 08/04/2019 |
| Patient Name | Baby MAHEK JAYANAT | Contact No | 9163350186 |
| Address | CHATRA MUSALMAN PARA | Age | 1.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||