Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00537 | Date 31/08/2018 |
| Token No | SM/18-19/627 31/08/2018 | Serial | 006 |
| Patient Name | Mrs. SANCHITA DEY | Contact No | |
| Address | DEY STREET | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | KG |
| Pulse Rate | 69 / min | Height | cm |
| Diagnosis | |||