Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00782 | Date 22/09/2018 |
| Token No | SM/18-19/1044 22/09/2018 | Serial | 024 |
| Patient Name | Mrs. SUKUNTALA DEBI | Contact No | |
| Address | DEY STREET | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 128/90 mmHg | Weight | 49 KG |
| Pulse Rate | 84 / min | Height | cm |
| Diagnosis | |||