Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04534 | Date 03/04/2019 |
| Token No | SM/19-20/211 03/04/2019 | Serial | 066 Last Visit: 03/04/2019 |
| Patient Name | Baby SONIYA SALMA | Contact No | |
| Address | RABINDA BHABAN | Age | 2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||