Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00303 | Date 28/08/2018 |
| Token No | SM/18-19/900 11/09/2018 | Serial | 031 |
| Patient Name | Mrs. HEMA MAITY | Contact No | |
| Address | Age | 54 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 123/76 mmHg | Weight | KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||