Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01078 | Date 05/10/2018 |
| Token No | SM/18-19/1403 05/10/2018 | Serial | 044 |
| Patient Name | Mrs. AMITA SANTRA | Contact No | |
| Address | DEY STREET | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 57 KG |
| Pulse Rate | 73 / min | Height | cm |
| Diagnosis | |||