Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09627 | Date 21/05/2021 |
| Token No | SM/21-22/1586 21/05/2021 | Serial | 002 Last Visit: 21/05/2021 |
| Patient Name | Baby SAKINA KHATUN | Contact No | 8478975006 |
| Address | CHATRA MUSHALMAN PARA SERAMPORE | Age | 2 Y 2M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||