Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01134 | Date 11/10/2018 |
| Token No | SM/18-19/1522 11/10/2018 | Serial | 013 |
| Patient Name | Baby RIKTA MONDAL | Contact No | |
| Address | RUDRARAM STREET | Age | 1 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||