Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00642 | Date 05/09/2018 |
| Token No | SM/18-19/811 05/09/2018 | Serial | 004 |
| Patient Name | Mrs. MAHUYA DEY | Contact No | |
| Address | DEY STREET | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/90 mmHg | Weight | KG |
| Pulse Rate | 80 / min | Height | cm |
| Diagnosis | |||