Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00700 | Date 13/09/2018 |
| Token No | SM/18-19/937 13/09/2018 | Serial | 026 |
| Patient Name | Mrs. KAKULI PAL | Contact No | |
| Address | DEY START | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 75 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||