Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00188 | Date 17/08/2018 |
| Token No | SM/18-19/201 17/08/2018 | Serial | 005 |
| Patient Name | Mrs. NABANITA DEY | Contact No | |
| Address | DEY STREET | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/60 mmHg | Weight | 45 KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||