Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00558 | Date 16/12/2019 |
| Token No | SM/19-20/3564 01/04/2020 | Serial | 005 |
| Patient Name | Baby ANKITA SARMA | Contact No | 8100825118 |
| Address | 180 NEW MAHESH CATA POL | Age | 2 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||