Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00101 | Date 07/08/2018 |
| Token No | SM/18-19/1424 13/09/2018 | Serial | 018 |
| Patient Name | Mrs. MILI MAHALANABISH | Contact No | |
| Address | BAT TALA | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/80 mmHg | Weight | KG |
| Pulse Rate | 100 / min | Height | cm |
| Diagnosis | |||