Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00734 | Date 18/09/2018 |
| Token No | SM/18-19/985 18/09/2018 | Serial | 012 |
| Patient Name | Baby NANDINI BISWAL | Contact No | 7003521703 |
| Address | 31A/2 CHOWDHURI PARA LANE | Age | 5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||