Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00941 | Date 24/09/2018 |
| Token No | SM/18-19/1222 24/09/2018 | Serial | 001 |
| Patient Name | Miss AMRITA KOLEY | Contact No | |
| Address | DEY STREET | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 60 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||