Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01021 | Date 28/09/2018 |
| Token No | SM/18-19/1326 28/09/2018 | Serial | 016 |
| Patient Name | Mrs. BIYADYA DEBI JAYWAYRA | Contact No | NOT GIVEN |
| Address | 10 NO DEY GHAT LANE | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 56 KG |
| Pulse Rate | 76 / min | Height | cm |
| Diagnosis | |||