Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01023 | Date 28/09/2018 |
| Token No | SM/18-19/1329 28/09/2018 | Serial | 019 |
| Patient Name | Mrs. PURNIMA BAG | Contact No | NOT GIVEN |
| Address | R R PANDIT LANE | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 45 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||