Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00026 | Date 03/08/2018 |
| Token No | SM/18-19/26 03/08/2018 | Serial | 007 |
| Patient Name | Mrs. PARBATI POLAI | Contact No | 8981419490 |
| Address | 8 INDIAN JUTE MILL | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 174/90 mmHg | Weight | KG |
| Pulse Rate | 90 / min | Height | cm |
| Diagnosis | |||