Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06063 | Date 06/08/2019 |
| Token No | SM/20-21/26485 10/10/2020 | Serial | 002 Last Visit: 10/10/2020 |
| Patient Name | Miss PUJA SHAW | Contact No | 9641044164 |
| Address | 21,CHATRA MUSALMAN PARA BEY LANE | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||