Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09975 | Date 23/08/2021 |
| Token No | SM/21-22/4301 23/08/2021 | Serial | 045 Last Visit: 30/10/2021 |
| Patient Name | Baby RABIYA KHATOON | Contact No | |
| Address | CHATRA MUSHALMAN PARA SERAMPORE | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||