Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00062 | Date 04/08/2018 |
| Token No | SM/18-19/62 04/08/2018 | Serial | 013 |
| Patient Name | Mrs. TRINA DAS | Contact No | |
| Address | Age | 59 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 120/90 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||