Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00100 | Date 06/08/2018 |
| Token No | SM/18-19/104 06/08/2018 | Serial | 031 |
| Patient Name | Mrs. GITA DEBI | Contact No | |
| Address | Age | 30 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||