Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00410 | Date 30/08/2018 |
| Token No | SM/18-19/468 30/08/2018 | Serial | 014 |
| Patient Name | Miss ASMITA PODDAR | Contact No | |
| Address | Age | 21 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 52 KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||