Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00521 | Date 30/08/2018 |
| Token No | SM/18-19/897 11/09/2018 | Serial | 028 |
| Patient Name | Mrs. SMITA PAL | Contact No | |
| Address | Age | 47 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 110/60 mmHg | Weight | KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||