Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09177 | Date 15/01/2021 |
| Token No | SM/20-21/29414 15/01/2021 | Serial | 047 Last Visit: 15/01/2021 |
| Patient Name | Baby SAYEDI KHATUN | Contact No | 7439263500 |
| Address | 12 CHATRA MUSALMAN PARA SERAMPORE | Age | 3 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||