Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06200 | Date 22/08/2019 |
| Token No | SM/19-20/8978 22/08/2019 | Serial | 043 Last Visit: 22/08/2019 |
| Patient Name | Baby SK ADWIK KHATUN | Contact No | |
| Address | 12 CHATRA MUSALMAN PARA , SERAMPORE | Age | 2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||