Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00717 | Date 14/09/2018 |
| Token No | SM/18-19/960 14/09/2018 | Serial | 012 |
| Patient Name | Baby PIYASHA KHAN | Contact No | |
| Address | CHATTERJEE LANE | Age | 4 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | 102 / min | Height | cm |
| Diagnosis | |||