Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00647 | Date 04/09/2018 |
| Token No | SM/18-19/832 04/09/2018 | Serial | 007 |
| Patient Name | Mrs. KAMALA SAHA | Contact No | |
| Address | Age | 52 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 130/82 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||