Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04451 | Date 28/03/2019 |
| Token No | SM/19-20/4928 20/06/2019 | Serial | 068 Last Visit: 20/06/2019 |
| Patient Name | Baby FIDOSHI KHATUN | Contact No | |
| Address | MUSALMAN PARA LANE TIKIYA PARA SERAMPORE (M) | Age | 4 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||