Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00911 | Date 10/09/2018 |
| Token No | SM/18-19/1191 10/09/2018 | Serial | 020 |
| Patient Name | Mrs. KAKOLI DEY | Contact No | 7890221544 |
| Address | DEY STREET | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/78 mmHg | Weight | 59 KG |
| Pulse Rate | 75 / min | Height | cm |
| Diagnosis | |||