Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00704 | Date 13/09/2018 |
| Token No | SM/18-19/941 13/09/2018 | Serial | 030 |
| Patient Name | Mrs. RIYA BALA | Contact No | |
| Address | DEY STREE | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 58 KG |
| Pulse Rate | 75 / min | Height | cm |
| Diagnosis | |||