Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00522 | Date 30/08/2018 |
| Token No | SM/18-19/607 30/08/2018 | Serial | 003 |
| Patient Name | Mrs. JOGITA MANNA | Contact No | |
| Address | Age | 50 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 138/74 mmHg | Weight | KG |
| Pulse Rate | 68 / min | Height | cm |
| Diagnosis | |||