Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05485 | Date 20/06/2019 |
| Token No | SM/19-20/11334 30/09/2019 | Serial | 007 Last Visit: 30/09/2019 |
| Patient Name | Baby DUBHAM DAS | Contact No | 8013541544 |
| Address | 21 N.N. ROY STREET | Age | 4 M 2 D Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||