Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00584 | Date 20/12/2019 |
| Token No | SM/19-20/1189 20/12/2019 | Serial | 005 |
| Patient Name | Baby DIPIKA PRASAD | Contact No | 6289185662 |
| Address | HINDI SCHOOL NAYABASTI SERAMPORE | Age | 3 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||