Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00264 | Date 11/08/2018 |
| Token No | SM/18-19/3060 04/04/2019 | Serial | 035 |
| Patient Name | Mrs. URMILA DEBI | Contact No | |
| Address | Age | 42 Y Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 124/84 mmHg | Weight | KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||