Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01431 | Date 19/12/2018 |
| Token No | SM/18-19/2040 19/12/2018 | Serial | 023 |
| Patient Name | Mrs. SUNANDA POALI | Contact No | NOT GIVEN |
| Address | DHARMATALA | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 61 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||