Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00198 | Date 17/08/2018 |
| Token No | SM/18-19/213 17/08/2018 | Serial | 017 |
| Patient Name | Mrs. G. ANITA | Contact No | |
| Address | COCKRAIN ROAD | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/30 mmHg | Weight | KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||