Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00697 | Date 13/09/2018 |
| Token No | SM/18-19/934 13/09/2018 | Serial | 023 |
| Patient Name | Miss JHUMPA DAS | Contact No | |
| Address | BELTING BAZAR | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 100/62 mmHg | Weight | 44 KG |
| Pulse Rate | 64 / min | Height | cm |
| Diagnosis | |||