Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00858 | Date 12/09/2018 |
| Token No | SM/18-19/1130 12/09/2018 | Serial | 020 |
| Patient Name | Baby TRISHA DHAR | Contact No | 9593862140 |
| Address | BATTALA | Age | 5 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 18 KG |
| Pulse Rate | 100 / min | Height | cm |
| Diagnosis | |||