Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01039 | Date 11/09/2018 |
| Token No | SM/19-20/9969 07/09/2019 | Serial | 038 Last Visit: 18/01/2020 |
| Patient Name | Baby MUSKAN KHATUN | Contact No | 7685984573 |
| Address | CHATRA MUSALMAN PARA | Age | 2 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||