Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00773 | Date 22/09/2018 |
| Token No | SM/18-19/1035 22/09/2018 | Serial | 015 |
| Patient Name | Mrs. PARUL BALA DEY | Contact No | |
| Address | DEY STREET | Age | 75 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/90 mmHg | Weight | 52 KG |
| Pulse Rate | 68 / min | Height | cm |
| Diagnosis | |||