Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07305 | Date 09/01/2020 |
| Token No | SM/19-20/19830 18/03/2020 | Serial | 004 Last Visit: 18/03/2020 |
| Patient Name | Baby ARTI DAS | Contact No | 7890714920 |
| Address | 8 KANAI DEWAN TALA BYE LANE | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||