Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00856 | Date 12/09/2018 |
| Token No | SM/18-19/1128 12/09/2018 | Serial | 018 |
| Patient Name | Miss SUMONA DEY | Contact No | 9093658241 |
| Address | DEY STREET | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/68 mmHg | Weight | 52 KG |
| Pulse Rate | 73 / min | Height | cm |
| Diagnosis | |||