Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06552 | Date 26/09/2019 |
| Token No | SM/19-20/11182 26/09/2019 | Serial | 066 Last Visit: 26/09/2019 |
| Patient Name | Baby DEEHAN GUHA | Contact No | 9433128053 |
| Address | 8 CHATRA DOL TALA , | Age | 4 Y 2 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||