Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00783 | Date 22/09/2018 |
| Token No | SM/18-19/1045 22/09/2018 | Serial | 025 |
| Patient Name | Baby NISHA SINGHA | Contact No | 8609542136 |
| Address | MANIKTALA | Age | 4 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | 112 / min | Height | cm |
| Diagnosis | |||