Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01454 | Date 20/12/2018 |
| Token No | SM/18-19/2072 20/12/2018 | Serial | 020 |
| Patient Name | Miss CHANDRA BAIRAGI | Contact No | |
| Address | DEY GHAT LANE | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 54 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||