Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01414 | Date 19/12/2018 |
| Token No | SM/18-19/2022 19/12/2018 | Serial | 005 |
| Patient Name | Miss DOLON MAJHI | Contact No | NOT GIVEN |
| Address | BATTALA | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 48 KG |
| Pulse Rate | 77 / min | Height | cm |
| Diagnosis | |||