Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00117 | Date 07/08/2018 |
| Token No | SM/18-19/122 07/08/2018 | Serial | 018 |
| Patient Name | Miss PUSPA SHAW | Contact No | NOT GIVEN |
| Address | R B SARANI | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||