Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00676 | Date 11/09/2018 |
| Token No | SM/18-19/911 11/09/2018 | Serial | 042 |
| Patient Name | Mrs. BELA SAHA | Contact No | |
| Address | Age | 64 Female | |
| Token For | Medicine, | Charge | Free |
| B.P | 142/78 mmHg | Weight | KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||