Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05453 | Date 15/06/2019 |
| Token No | SM/19-20/4680 15/06/2019 | Serial | 063 Last Visit: 15/06/2019 |
| Patient Name | Baby PIYA DAS | Contact No | 7044773658 |
| Address | CHATRA MUSALMANPARA /LANE | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||