Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00851 | Date 12/09/2018 |
| Token No | SM/18-19/1123 12/09/2018 | Serial | 013 |
| Patient Name | Mrs. KONOK DEB | Contact No | |
| Address | BATTALA | Age | 43 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 124/78 mmHg | Weight | 58 KG |
| Pulse Rate | 71 / min | Height | cm |
| Diagnosis | |||