Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02868 | Date 21/08/2019 |
| Token No | SM/18-19/5818 21/08/2019 | Serial | 035 |
| Patient Name | Baby SHIBANGI RAJBHAR | Contact No | 9073782548 |
| Address | 10 DEY STREET | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||