Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00762 | Date 22/09/2018 |
| Token No | SM/18-19/1024 22/09/2018 | Serial | 004 |
| Patient Name | Miss MOUMITA DEBNATH | Contact No | 7001256897 |
| Address | DEY STREE | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 100/60 mmHg | Weight | 40 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||