Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01422 | Date 19/12/2018 |
| Token No | SM/18-19/2031 19/12/2018 | Serial | 014 |
| Patient Name | Mrs. SUJATA MAITY | Contact No | |
| Address | BATTALA | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 57 KG |
| Pulse Rate | 76 / min | Height | cm |
| Diagnosis | |||