Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00037 | Date 03/08/2018 |
| Token No | SM/18-19/37 03/08/2018 | Serial | 018 |
| Patient Name | Mrs. SABITRI BARIK | Contact No | |
| Address | Age | 55 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 120/85 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||