Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00134 | Date 08/08/2018 |
| Token No | SM/18-19/139 08/08/2018 | Serial | 005 |
| Patient Name | Mrs. MADHUMITA SAMANTA | Contact No | 9830857411 |
| Address | DEY STREET | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | KG |
| Pulse Rate | 68 / min | Height | cm |
| Diagnosis | |||