Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00575 | Date 16/08/2018 |
| Token No | SM/18-19/677 16/08/2018 | Serial | 001 |
| Patient Name | Mrs. ALO RANI DEY | Contact No | |
| Address | DEY STREET | Age | 64 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||