Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01500 | Date 22/12/2018 |
| Token No | SM/18-19/2125 22/12/2018 | Serial | 002 |
| Patient Name | Mrs. CHANDRA PRAMANIK | Contact No | |
| Address | MANIK TALA | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 55 KG |
| Pulse Rate | 77 / min | Height | cm |
| Diagnosis | |||