Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01514 | Date 22/12/2018 |
| Token No | SM/18-19/2139 22/12/2018 | Serial | 016 |
| Patient Name | Miss BIDISHA SASMOL | Contact No | NOT GIVEN |
| Address | Age | 22 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 54 KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||