Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01338 | Date 06/12/2018 |
| Token No | SM/18-19/1885 06/12/2018 | Serial | 004 |
| Patient Name | Mrs. LUSY DEY | Contact No | 9477045309 |
| Address | 5/A DEY STREET | Age | 58 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||