Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04861 | Date 23/04/2019 |
| Token No | SM/19-20/1487 23/04/2019 | Serial | 068 Last Visit: 23/04/2019 |
| Patient Name | Miss AISA KHATUN | Contact No | 7278658023 |
| Address | 7 ARBINDA SARANI SERAMPORE | Age | 2.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||