Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00039 | Date 03/08/2018 |
| Token No | SM/18-19/1239 25/09/2018 | Serial | 001 |
| Patient Name | Mrs. JAYANTI PRADHAN | Contact No | 7595883317 |
| Address | 13 DEY STREET | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 39 KG |
| Pulse Rate | 82 / min | Height | cm |
| Diagnosis | |||