Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06478 | Date 20/09/2019 |
| Token No | SM/19-20/10740 20/09/2019 | Serial | 031 Last Visit: 20/09/2019 |
| Patient Name | Baby TIYA KUMARI | Contact No | 8482031975 |
| Address | CHATRA MUSALMAN PARA SERAMPORE | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||