Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00047 | Date 03/08/2018 |
| Token No | SM/18-19/47 03/08/2018 | Serial | 028 |
| Patient Name | Mrs. KUNTI DEBI | Contact No | |
| Address | Age | 45 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 136/86 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||