Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00010 | Date 02/08/2018 |
| Token No | SM/18-19/623 31/08/2018 | Serial | 002 |
| Patient Name | Mrs. GYANTI DEBI | Contact No | |
| Address | DEY GHAT LANE | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||