Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07364 | Date 17/01/2020 |
| Token No | SM/19-20/16830 17/01/2020 | Serial | 051 Last Visit: 17/01/2020 |
| Patient Name | Baby SHARIKA KHATUN | Contact No | 8697144683 |
| Address | 30A CHATRA MUSALMAN PARA SERAMPORE | Age | 2.4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||