Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 08160 | Date 27/04/2020 |
| Token No | SM/19-20/21646 27/04/2020 | Serial | 073 Last Visit: 27/04/2020 |
| Patient Name | Baby ADAIB | Contact No | 8100120576 |
| Address | 57 N.N. ROY STREET ROY GHAT | Age | 4YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||