Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01000 | Date 27/09/2018 |
| Token No | SM/18-19/1301 27/09/2018 | Serial | 041 |
| Patient Name | Baby DIPSIKHA DEY | Contact No | 7073554211 |
| Address | BATTALA | Age | 6 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | 108 / min | Height | cm |
| Diagnosis | |||