Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01491 | Date 20/12/2018 |
| Token No | SM/18-19/2109 20/12/2018 | Serial | 057 |
| Patient Name | Mrs. PAMELA ROY | Contact No | NOT GIVEN |
| Address | Age | 36 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 124/84 mmHg | Weight | 54 KG |
| Pulse Rate | 77 / min | Height | cm |
| Diagnosis | |||