Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04503 | Date 15/06/2021 |
| Token No | SM/21-22/443 15/06/2021 | Serial | 013 |
| Patient Name | Baby ALOKA HANSDA | Contact No | NOT GIVEN |
| Address | ARAMBAGH | Age | 1 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||