Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00915 | Date 10/09/2018 |
| Token No | SM/18-19/1195 10/09/2018 | Serial | 004 |
| Patient Name | Mrs. BARNALI MAHANTO | Contact No | |
| Address | Age | 27 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 62 KG |
| Pulse Rate | 75 / min | Height | cm |
| Diagnosis | |||