Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01024 | Date 28/09/2018 |
| Token No | SM/18-19/1330 28/09/2018 | Serial | 020 |
| Patient Name | Mrs. ASIMA MANNA | Contact No | NOT GIVEN |
| Address | COCKRAIN LANE | Age | 34 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/78 mmHg | Weight | 64 KG |
| Pulse Rate | 70 / min | Height | cm |
| Diagnosis | |||