Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07361 | Date 17/01/2020 |
| Token No | SM/19-20/16820 17/01/2020 | Serial | 041 Last Visit: 17/01/2020 |
| Patient Name | Baby AYESHA KHATUN | Contact No | 9123371065 |
| Address | 58 NO MUSALMAN PARA CHATRA SERAMPORE | Age | 3 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 3.64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||