Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00746 | Date 19/09/2018 |
| Token No | SM/18-19/999 19/09/2018 | Serial | 009 |
| Patient Name | Baby ASMITA DEY | Contact No | |
| Address | DEY STREE | Age | 4 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | 110 / min | Height | cm |
| Diagnosis | |||