Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00703 | Date 13/09/2018 |
| Token No | SM/18-19/940 13/09/2018 | Serial | 029 |
| Patient Name | Miss PRIYA DAS | Contact No | NOT GIVEN |
| Address | CHATRA | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 51 KG |
| Pulse Rate | 74 / min | Height | cm |
| Diagnosis | |||