Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00613 | Date 21/08/2018 |
| Token No | SM/18-19/881 11/09/2018 | Serial | 012 |
| Patient Name | Mrs. ALOKA BHAR | Contact No | |
| Address | PAL BAGAN | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 132/74 mmHg | Weight | KG |
| Pulse Rate | 78 / min | Height | cm |
| Diagnosis | |||