Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07634 | Date 26/02/2020 |
| Token No | SM/19-20/18673 26/02/2020 | Serial | 016 Last Visit: 27/02/2020 |
| Patient Name | Baby TANUJA KHATUN | Contact No | 8334920722 |
| Address | 1 FATUA BARI CHATRA MUSALMAN PARA | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||