Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01069 | Date 05/10/2018 |
| Token No | SM/18-19/1394 05/10/2018 | Serial | 035 |
| Patient Name | Mrs. MAMPI PORE | Contact No | 7477859201 |
| Address | DEY GHAT | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 59 KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||