Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00586 | Date 16/08/2018 |
| Token No | SM/18-19/688 16/08/2018 | Serial | 012 |
| Patient Name | Mrs. PRABHATI DEY | Contact No | 8013303753 |
| Address | DEY STREET | Age | 68 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 158/90 mmHg | Weight | KG |
| Pulse Rate | 78 / min | Height | cm |
| Diagnosis | |||