Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01547 | Date 04/01/2019 |
| Token No | SM/18-19/3954 04/06/2019 | Serial | 009 |
| Patient Name | Baby ICCHA KUMARI | Contact No | NOT GIVEN |
| Address | 10 JUTE MILL | Age | 1 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||