Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01796 | Date 13/03/2019 |
| Token No | SM/18-19/2821 13/03/2019 | Serial | 011 |
| Patient Name | Baby PRITAM KUMAR SHA | Contact No | 8229990836 |
| Address | INDIA JUTE MILL | Age | 1 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||