Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01022 | Date 28/09/2018 |
| Token No | SM/18-19/1328 28/09/2018 | Serial | 018 |
| Patient Name | Mrs. SUSHILA PRADHAN | Contact No | NOT GIVEN |
| Address | PAL BAGAN | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 54 KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||