Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00011 | Date 02/08/2018 |
| Token No | SM/18-19/11 02/08/2018 | Serial | 010 |
| Patient Name | Mrs./Miss SAMACHAITA DEY | Contact No | |
| Address | Age | 27 Female | |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | 110/60 mmHg | Weight | KG |
| Pulse Rate | 75 / min | Height | cm |
| Diagnosis | |||