Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00686 | Date 13/09/2018 |
| Token No | SM/18-19/923 13/09/2018 | Serial | 012 |
| Patient Name | Mrs. MADHU SOM | Contact No | |
| Address | NOTUN BAGAN LANE | Age | 63 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 126/78 mmHg | Weight | 52 KG |
| Pulse Rate | 72 / min | Height | cm |
| Diagnosis | |||