Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00942 | Date 24/09/2018 |
| Token No | SM/18-19/1223 24/09/2018 | Serial | 002 |
| Patient Name | Mrs. MADHUMITA KOLEY | Contact No | 9869895825 |
| Address | DEY STREET | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||