Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00458 | Date 14/08/2018 |
| Token No | SM/18-19/528 14/08/2018 | Serial | 042 |
| Patient Name | Miss MANISHA SARKAR | Contact No | NOT GIVEN |
| Address | CHATRA | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||