Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06064 | Date 06/08/2019 |
| Token No | SM/19-20/11892 17/10/2019 | Serial | 002 Last Visit: 10/10/2020 |
| Patient Name | Baby RIYA SHAW | Contact No | 9641044164 |
| Address | 21 CHATRA MUSALMAN PARA | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||