Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00765 | Date 22/09/2018 |
| Token No | SM/18-19/1027 22/09/2018 | Serial | 007 |
| Patient Name | Mrs. SUMI DEY | Contact No | 9736485214 |
| Address | DEY STREE | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 54 KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||