Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00972 | Date 25/09/2018 |
| Token No | SM/18-19/1259 25/09/2018 | Serial | 021 |
| Patient Name | Mrs. CHHABI SAMANTA | Contact No | NOT GIVEN |
| Address | CHOWDHURI PARA LANE | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 45 KG |
| Pulse Rate | 78 / min | Height | cm |
| Diagnosis | |||