Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00512 | Date 20/08/2018 |
| Token No | SM/18-19/596 20/08/2018 | Serial | 043 |
| Patient Name | Mrs. SABITRI SEN | Contact No | |
| Address | Age | 49 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 144/90 mmHg | Weight | KG |
| Pulse Rate | 82 / min | Height | cm |
| Diagnosis | |||