Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00977 | Date 27/09/2018 |
| Token No | SM/18-19/1264 27/09/2018 | Serial | 004 |
| Patient Name | Mrs. SUSHILA PARIDA | Contact No | NOT GIVEN |
| Address | 9 NO LINE JUTE MILL | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 90/60 mmHg | Weight | 42 KG |
| Pulse Rate | 80 / min | Height | cm |
| Diagnosis | |||