Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01007 | Date 27/09/2018 |
| Token No | SM/18-19/1308 27/09/2018 | Serial | 048 |
| Patient Name | Miss TIASHA DAS | Contact No | |
| Address | 2 NO DHARMATALA | Age | 17 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 100/60 mmHg | Weight | 39 KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||