Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07696 | Date 02/03/2020 |
| Token No | SM/19-20/24687 03/08/2020 | Serial | 030 Last Visit: 03/08/2020 |
| Patient Name | Miss FATMA KHATUN | Contact No | 8981818260 |
| Address | 18 MUSALMAN PARA BYE LANE SERAMPORE | Age | 5.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||