Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00371 | Date 13/08/2018 |
| Token No | SM/18-19/421 13/08/2018 | Serial | 028 |
| Patient Name | Miss PIYALI SAHA | Contact No | |
| Address | 2 NO DHARMATALA | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||