Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00422 | Date 30/08/2018 |
| Token No | SM/18-19/482 30/08/2018 | Serial | 028 |
| Patient Name | Mrs. SUSAMA DAS | Contact No | |
| Address | PAL BAGAN | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 55 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||