Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01434 | Date 19/12/2018 |
| Token No | SM/18-19/2043 19/12/2018 | Serial | 026 |
| Patient Name | Miss DOLON SARKAR | Contact No | NOT GIVEN |
| Address | Age | 24 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 51 KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||