Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00250 | Date 24/08/2018 |
| Token No | SM/18-19/270 24/08/2018 | Serial | 007 |
| Patient Name | Miss PURBASHA DAS | Contact No | |
| Address | Age | 22 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||