Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00370 | Date 13/08/2018 |
| Token No | SM/18-19/4996 20/07/2019 | Serial | 006 |
| Patient Name | Baby ASHMIKA MALLICKA | Contact No | |
| Address | Age | 5 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||