Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01020 | Date 28/09/2018 |
| Token No | SM/18-19/1325 28/09/2018 | Serial | 015 |
| Patient Name | Miss GITA KUMARI | Contact No | 9775482613 |
| Address | CHOWDHURY PARA LANE | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | 110 / min | Height | cm |
| Diagnosis | |||